The influence of early transplantation, age, GVHD prevention regimen, and other factors on outcome of allogeneic transplantation for CML following BuCy
Autor: | M D Scholl, D C Young, M B Tighe, K S Theil, P S Belt, Belinda R. Avalos, Sam Penza, Edward A. Copelan, Patrick Elder, T P Bechtel, S A Ezzone |
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Rok vydání: | 2000 |
Předmět: |
Adult
Male medicine.medical_specialty Allogeneic transplantation Adolescent Cyclophosphamide medicine.medical_treatment Fusion Proteins bcr-abl Hepatic Veno-Occlusive Disease Graft vs Host Disease Gastroenterology Recurrence Cause of Death Internal medicine medicine Humans Transplantation Homologous Busulfan Aged Bone Marrow Transplantation Transplantation Chemotherapy business.industry Age Factors Hematology Middle Aged Surgery Leukemia Myeloid Acute Regimen surgical procedures operative Methylprednisolone Chemoprophylaxis Female business medicine.drug |
Zdroj: | Bone Marrow Transplantation. 26:1037-1043 |
ISSN: | 1476-5365 0268-3369 |
DOI: | 10.1038/sj.bmt.1702689 |
Popis: | Results in 164 patients who underwent allogeneic marrow transplantation following busulfan and cyclophosphamide over a 15 year period were analyzed. Age (median 37, range 14-66 years) did not significantly affect the incidence of graft-versus-host disease (GVHD), but patients who received methotrexate with cyclosporine had a significantly lower incidence (P = 0.002) of chronic GVHD compared to those who received methylprednisolone with cyclosporine. Hepatic veno-occlusive disease (VOD) occurred less frequently in chronic phase patients (P = 0.002) and in those transplanted shortly after diagnosis (P = 0.001). Five year leukemia-free survival (LFS) for the entire group was 49% (95% CI 41-57%). For 102 patients who underwent transplantation in chronic phase, results were significantly improved by transplantation at a short interval following diagnosis, particularly within 3 months (P = 0.01), by the use of methotrexate and not corticosteroids for GVHD prevention (P = 0.03), and by use of HLA-identical sibling donors (P = 0.01). Age was not a significant adverse prognostic factor and transplantation was successfully performed in individuals up to age 66. Allogeneic transplantation in CML, including older patients and those with unrelated donors, can be most safely and effectively performed shortly after diagnosis. |
Databáze: | OpenAIRE |
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