Reduced-intensity conditioning using TBI (8 Gy), fludarabine, cyclophosphamide and ATG in elderly CML patients provides excellent results especially when performed in the early course of the disease
| Autor: | Claudia Schoch, B. Rolf, Michael Schleuning, Kolb Hj, Martin Weisser, Georg Ledderose, Rainer Schwerdtfeger, Susanne Schnittger |
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| Rok vydání: | 2004 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Transplantation Conditioning Cyclophosphamide medicine.medical_treatment Hematopoietic stem cell transplantation Gastroenterology Recurrence Internal medicine Leukemia Myelogenous Chronic BCR-ABL Positive Antineoplastic Combined Chemotherapy Protocols medicine Humans Transplantation Homologous Antilymphocyte Serum Transplantation business.industry Graft Survival Hematopoietic Stem Cell Transplantation Dose-Response Relationship Radiation Hematology Total body irradiation Middle Aged medicine.disease Combined Modality Therapy Survival Analysis Surgery Fludarabine Graft-versus-host disease Female business Vidarabine Whole-Body Irradiation Chronic myelogenous leukemia medicine.drug Follow-Up Studies |
| Zdroj: | Bone marrow transplantation. 34(12) |
| ISSN: | 0268-3369 |
| Popis: | Allogeneic bone marrow or stem cell transplantation is a curative therapeutic option for chronic myelogenous leukemia. In order to decrease the toxicity of the procedure, the dosage of total body irradiation was reduced from 12 to 8 Gy and subsequently the dose of cyclophosphamide from 120 to 80 mg/kg. The purine analogue fludarabine, ATG, cyclosporine A and a short course of methotrexate were given for immune suppression. So far, 35 elderly CML patients with sibling and unrelated donors have been transplanted. Transplant-related mortality at day + 100 was 11%. After engraftment, all patients achieved a complete cytogenetic remission. Relapse occurred in 14% of the patients. The risk of relapse was significantly higher in those patients transplanted in second chronic or accelerated phase (P = 0.048). After a median follow-up of 30 months (range 12-62), 63% of the patients are alive. Those patients transplanted within the first year from diagnosis had an overall survival of 79% (P = 0.049), emphasizing the benefit of early transplantation. Stepwise reduction of conditioning intensity resulted in stable engraftment, low relapse rates and encouraging overall survival in this high-risk patient group. |
| Databáze: | OpenAIRE |
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