| Autor: |
Barker, Juliet N., Davies, Stella M., DeFor, Todd E., Burns, Linda J., McGlave, Philip B., Miller, Jeffrey S., Weisdorf, Daniel J. |
| Předmět: |
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| Zdroj: |
British Journal of Haematology; Jul2002, Vol. 118 Issue 1, p101-107, 8p |
| Abstrakt: |
Summary. Unrelated donor (URD) bone marrow transplantation (BMT) in adults can be associated with high non-relapse mortality (NRM). Therefore, factors determining survival in 136 human leucocyte antigen (HLA)-A, B, DRB1-matched adult BMT recipients were reviewed. Fifty-four per cent of patients had chronic myelogenous leukaemia (CML) and 36% had acute leukaemia or myelodysplasia. Graft-versus-host disease (GvHD) prophylaxis was either cyclosporin A (CSA)/methotrexate (64%) or T-cell depletion and CSA/corticosteroids (34%). The probability of donor engraftment by d 45 was 97% (95% CI: 94–100). Incidence of grades III–IV acute GvHD was 18% (95% CI: 12–24) at 100 d, and chronic GvHD was 42% (95% CI: 32–52) at 2 years. At 2 years, 14% (95% CI: 8–20) had relapsed. Multiple regression analysis showed that adverse risk factors for survival were non-CML diagnosis, age > 35 years, diagnosis to transplant time of > 18 months [chronic-phase CML (CML-CP) only]; and grades III–IV acute GvHD. Patients ≤ 35 years with early CML-CP had a 2 year survival of 77% (95% CI: 54–100), which compared with a survival in advanced CML patients ≤35 years of 67% (95% CI: 37–97) and 37% (95% CI: 20–54) in non-CML patients. Two year survival for patients > 35 years with early CML-CP was 55% (95% CI: 33–77), 40% (95% CI: 19–61) in advanced CML and 14% (95% CI:1–27) in non-CML. Future efforts should focus on improving the outcome for older BMT recipients, especially those with diagnoses other than CML. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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