[Transplantations of allogenic and autologous hemopoietic stem cells in acute leukemia (results of 20-year experience)].
| Autor: | Savchenko VG, Liubimova LS, Parovichnikova EN, Mendeleeva LP, Mamotiuk KS, Demidova IA, Gribanova EO, Gal'tseva IV, Pokrovskaia OS, Kuz'mina LA, Zhelnova EI, Kliasova GA, Glasko EN, Kaplanskaia IB, Poreshina LP, Kut'ina RM, Shpakova AP, Shtareva EM, Varlamova SV, Kalinin NN |
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| Jazyk: | ruština |
| Zdroj: | Terapevticheskii arkhiv [Ter Arkh] 2007; Vol. 79 (7), pp. 30-5. |
| Abstrakt: | Aim: To analyse results of transplantation of allogenic and autologous hemopoietic stem cells (allo-THSC and auto-THSC) with myeloablation preconditioning in patients with acute leukemia (AL) performed in 1987-2006. Material and Methods: A total of 71 allogenic and 45 autologous THSC were performed in 116 patients with different AL variants. Conditioning in all allo-THSC included busulfan (16 mg/kg) and cyclophosphamide (120 mg/kg). This regimen was used in 29 recipients of auto-HSC. Cyclophosphamide in a dose 120 mg/kg and total radiation of the body in a dose 12 Gy were given to 16 recipients. Overall, relapse-free and event-free survival of patients after THSC were analysed as well as early (first 100 days) and overall lethality. Auto-THSC in 15 patients was for the first time followed by immunomodulating therapy aimed at prevention of AL relapses: in acute myeloid leukemia ATRA in combination with alpha-interferon, in acute lymphoblastic leukemia (ALL)--ronkoleukin, interleukin-2 preparation. Results: Overall survival of AL patients after allo-THSC for the observation period increased from 31 to 58%, early lethality fell from 44 to 4%. Results of allo-THSC conducted in the first complete remission were much better than in patients with other AL stages at the time of THSC. After auto-THSC 5-year survival rose from 22 to 60% while early lethality reduced from 33 to 4%. Administration of immunomodulating therapy after auto-THSC increases 5-year survival from 35 to 80%. Conclusion: Outcomes of THSC in AL has improved for the last 20 years. Outcomes of allo-THSC performed in the first complete remission are much higher. Immunomodulating therapy after auto-THSC promoted better results. |
| Databáze: | MEDLINE |
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