Bone marrow transplantation for patients with chronic myeloid leukemia
| Autor: | John M. Goldman, Jane F. Apperley, Lydia Jones, Robert Marcus, Alan W.G. Goolden, Richard Batchelor, Geoffrey Hale, Herman Waldmann, Cecil D. Reid, Jill Hows, Edward Gordon-Smith, Daniel Catovsky, David A.G. Galton |
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| Rok vydání: | 1986 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.medical_treatment T-Lymphocytes Splenectomy Graft vs Host Disease Cell Separation Postoperative Complications HLA Antigens medicine Humans Child Cyclophosphamide Bone Marrow Transplantation business.industry Myeloid leukemia Immunosuppression General Medicine Middle Aged medicine.disease Combined Modality Therapy Tissue Donors Surgery Transplantation Leukemia medicine.anatomical_structure Graft-versus-host disease Leukemia Myeloid Female Bone marrow business Chemoradiotherapy Spleen Follow-Up Studies |
| Zdroj: | The New England journal of medicine. 314(4) |
| ISSN: | 0028-4793 |
| Popis: | Between February 1981 and December 1984 we treated 52 patients with chronic myeloid leukemia in the chronic phase and 18 patients with more advanced disease by high-dose chemoradiotherapy followed by allogeneic bone marrow transplantation using marrow cells from HLA-identical sibling donors. In addition, the 40 patients who had not previously undergone splenectomy received radiotherapy to the spleen. To prevent graft versus host disease, cyclosporine was given either alone or in conjunction with donor marrow depleted of T cells. Of the 52 patients treated in the chronic phase, 38 are alive after a median follow-up of 25 months (range, 7 to 50); the actuarial survival at two years was 72 percent, and the actuarial risk of relapse was 7 percent. Of the 18 patients with more advanced disease, 4 have survived; the actuarial two-year survival was 18 percent, and the actuarial risk of relapse was 42 percent. We conclude that the probability of cure is highest if transplantation is performed while the patient remains in the chronic phase of chronic myeloid leukemia. T-cell depletion may have reduced the incidence and severity of graft versus host disease. The value of irradiation to the spleen before transplantation has not been established. |
| Databáze: | OpenAIRE |
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