Predictors of relapse and overall survival in Philadelphia chromosome-positive acute lymphoblastic leukemia after transplantation
| Autor: | Kris Doney, Frederick R. Appelbaum, Lan Beppu, Eileen Bryant, Ted Gooley, Jerald P. Radich, Derek L. Stirewalt, Katherine A. Guthrie |
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| Rok vydání: | 2003 |
| Předmět: |
Oncology
Adult Male medicine.medical_specialty Neoplasm Residual Adolescent Lymphoblastic Leukemia Fusion Proteins bcr-abl Philadelphia chromosome Predictive Value of Tests Recurrence Internal medicine Overall survival Medicine Humans Transplantation Homologous Philadelphia Chromosome RNA Neoplasm Child Retrospective Studies Transplantation business.industry Hematopoietic Stem Cell Transplantation Hematology Middle Aged Precursor Cell Lymphoblastic Leukemia-Lymphoma medicine.disease Prognosis Survival Rate Child Preschool Female business |
| Zdroj: | Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation. 9(3) |
| ISSN: | 1083-8791 |
| Popis: | Allogeneic transplantation offers a potential cure for patients with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL). We performed a retrospective analysis examining pretransplantation and posttransplantation prognostic factors in 90 patients with Ph+ ALL. The median age of the patients was 33 years, with slightly more than half of the patients (58%) in clinical remission at the time of transplantation. Overall, patients had a nonrelapse mortality rate of 30%, a relapse percentage of 34%, and an estimated 5-year disease-free survival rate of 30%. Pretransplantation risk factors for relapse included the expression of the p190 transcript (relative risk [RR] = 5.1; P =.037), evidence of morphologic disease at the time of transplantation (RR = 3.9; P.001), and type of donor (RR = 2.5; P =.015), with patients receiving autologous or matched related transplants having the highest risk of relapse. The detection of minimal residual disease by reverse transcription polymerase chain reaction for bcr-abl transcripts was a significant posttransplantation risk factor for relapse (RR = 4.4; P =.001), with posttransplantation patients expressing the p190 transcript having the highest risk of relapse (RR = 8.7; P =.0001). In addition, patients with chronic extensive graft-versus-host disease showed a significantly lower risk of relapse (RR = 0.33; P =.038). Thus, these findings indicate that several pretransplantation and posttransplantation risk factors exist for patients with Ph+ ALL. Together, these factors can be used to improve our risk stratification of patients with Ph+ ALL who undergo transplantation, which will greatly enhance our ability to counsel these patients and potentially lead to the development of more specific treatment plans for them. |
| Databáze: | OpenAIRE |
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