| Autor: |
Gupta V; Blood and Marrow Transplant Program, Princess Margaret Hospital, Toronto, Ontario, Canada. vikas.gupta@uhn.on.ca, Daly A, Lipton JH, Hasegawa W, Chun K, Kamel-Reid S, Tsang R, Yi QL, Minden M, Messner H, Kiss T |
| Jazyk: |
angličtina |
| Zdroj: |
Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation [Biol Blood Marrow Transplant] 2005 Oct; Vol. 11 (10), pp. 764-72. |
| DOI: |
10.1016/j.bbmt.2005.06.006 |
| Abstrakt: |
We analyzed the outcomes of 24 consecutive patients aged >or=60 years with poor-prognosis myelodysplastic syndrome or acute myeloid leukemia undergoing transplantation with nonmyeloablative conditioning using fludarabine (125 mg/m2) and low-dose total body irradiation (2 Gy) followed by allogeneic peripheral blood stem cell grafts from HLA-identical sibling donors. Graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporine and mycophenolate mofetil. The median age of the patients was 64 years (range, 60-71 years). In addition to age, 88% of patients had 1 or more adverse biological features of the disease. With a median follow-up of 21 months, 12 patients are alive, 11 of whom are disease free. The probabilities of 2-year overall and progression-free survival were 52% and 44%, respectively. The cumulative probabilities of relapse and of acute and chronic GVHD were 27%, 45%, and 74%, respectively. Nonrelapse mortality at 100 days and 2 years was 8% and 25%, respectively. Of the 15 patients with extensive chronic GVHD, 1 patient relapsed. These data suggest that nonmyeloablative stem cell transplantation is a feasible treatment option in patients aged >or=60 years with poor-prognosis myelodysplastic syndrome or acute myeloid leukemia. The reasonable disease control with nonmyeloablative transplantation in this high-risk group of patients merits further investigation. |
| Databáze: |
MEDLINE |
| Externí odkaz: |
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