Unrelated donor marrow transplantation for acute myeloid leukemia: an update of the Seattle experience
| Autor: | Barry E. Storer, Jorge Sierra, Jean E. Sanders, Dana C. Matthews, Ann E. Woolfrey, P.J. Martin, FR Appelbaum, Effie W. Petersdorf, Rainer Storb, Claudio Anasetti, John A. Hansen |
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| Rok vydání: | 2000 |
| Předmět: |
Adult
Male Washington medicine.medical_specialty Transplantation Conditioning Adolescent Primary Induction Failure Cyclophosphamide Graft vs Host Disease Gastroenterology Disease-Free Survival Recurrence Unrelated Donor Internal medicine medicine Humans Prospective Studies Child Bone Marrow Transplantation Transplantation business.industry Graft Survival Infant Myeloid leukemia Hematology Middle Aged Total body irradiation Tissue Donors Surgery Survival Rate Treatment Outcome medicine.anatomical_structure Leukemia Myeloid Child Preschool Acute Disease Female Methotrexate Bone marrow business Follow-Up Studies medicine.drug |
| Zdroj: | Bone Marrow Transplantation. 26:397-404 |
| ISSN: | 1476-5365 0268-3369 |
| Popis: | Between 1985 and 1998, 161 patients with primary acute myeloid leukemia (AML) received T-replete bone marrow transplantation (BMT) from unrelated donors in Seattle. Median age was 30 (range 1–55) years. Conditioning for BMT consisted of cyclophosphamide and total body irradiation in 154 (96%) cases and graft-versus-host disease prophylaxis was the standard methotrexate and cyclosporine combination in 134 (83%) cases. Median post-transplant follow-up was 2.9 years. Leukemia-free survival (LFS) at 5 years was 50 ± 12% for transplants during first complete remission (n = 16), 28 ± 8% during second CR (n = 40), 27 ± 17% during subsequent CR (n = 8), 7 ± 3% during relapse (n = 81) and 19 ± 10% during primary induction failure (n = 16). The cumulative incidences of relapse were 19%, 23%, 25%, 44% and 63%, for the five groups, respectively. Transplantation during remission, a marrow cell dose above 3.5 × 108/kg, and cytomegalovirus seronegative status before BMT in both patient and donor were favorable prognostic factors. Adults in any CR who received a marrow cell dose above 3.5 × 108/mg had a LFS of 54 ± 9% at 5 years. These data extend our previous findings on the association between a high marrow cell dose and improved survival and support the use of unrelated donor BMT for treatment of patients with high risk AML when a family match is not available. Bone Marrow Transplantation (2000) 26, 397–404. |
| Databáze: | OpenAIRE |
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