|
|
 Previous Article | Table of Contents | Next Article 
HLA-identical marrow transplantation during accelerated-phase chronic
myelogenous leukemia: analysis of survival and remission duration
PJ Martin, RA Clift, LD Fisher, CD Buckner, JA Hansen, FR Appelbaum, KC Doney, KM Sullivan, RP Witherspoon and R Storb
Division of Clinical Research, Fred Hutchinson Cancer Research Center,
Seattle, WA 98104.
Results of HLA-identical allogeneic marrow transplantation were analyzed
for 66 patients with accelerated-phase chronic myelogenous leukemia (CML).
Multivariate proportional hazards regression models were used to determine
disease-related and transplant-related factors associated with
posttransplant mortality and relapse. The projected 5- year survival rate
was estimated at 18% by the product-limit method. The major causes of death
were interstitial pneumonia, infection, and relapse. Splenomegaly at
initial diagnosis and longer time interval from diagnosis to transplant
were associated with decreased overall survival and event-free survival.
Sixteen patients have relapsed between 17 and 1,569 days (median, 486)
posttransplant. The use of T- cell-depleted marrow and older age of the
donor or recipient were associated with an increased probability of
leukemic relapse. Ten of the 16 relapses occurred among the 15 patients who
received T-cell- depleted marrow. The actuarial relapse risk 2.5 years
posttransplant was 100% in patients administered T-cell-depleted marrow as
compared with 25% in patients administered unmodified marrow. The data in
this report emphasize the increased risks and relatively poor results that
occur when marrow transplantation is deferred until after signs of
acceleration appear. When compared with results for patients who received
transplants during chronic phase, the poor results seen here in patients
administered unmodified marrow stem primarily from increased
transplant-related mortality rather than increased relapse risk. The
strikingly increased relapse rate associated with the use of T-cell
depletion would discourage its use for graft-v-host disease prevention in
patients who receive transplants for CML.
Volume 72,
Issue 6,
pp. 1978-1984,
12/01/1988
Copyright © 1988 by The American Society of Hematology
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati What's this?
This article has been cited by other articles:
|
|
|
|
 
F. Carnevale-Schianca, A. Cignetti, A. Capaldi, K. Vitaggio, A. Vallario, A. Ricchiardi, E. Sperti, R. Ferraris, M. Gatti, G. Grignani, et al.
Allogeneic nonmyeloablative hematopoietic cell transplantation in metastatic colon cancer: tumor-specific T cells directed to a tumor-associated antigen are generated in vivo during GVHD
Blood,
May 1, 2006;
107(9):
3795 - 3803.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
V. T. Ho and R. J. Soiffer
The history and future of T-cell depletion as graft-versus-host disease prophylaxis for allogeneic hematopoietic stem cell transplantation
Blood,
December 1, 2001;
98(12):
3192 - 3204.
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. A. Nash, J. H. Antin, C. Karanes, J. W. Fay, B. R. Avalos, A. M. Yeager, D. Przepiorka, S. Davies, F. B. Petersen, P. Bartels, et al.
Phase 3 study comparing methotrexate and tacrolimus with methotrexate and cyclosporine for prophylaxis of acute graft-versus-host disease after marrow transplantation from unrelated donors
Blood,
September 15, 2000;
96(6):
2062 - 2068.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Guglielmi, W. Arcese, J. Hermans, A. Bacigalupo, G. Bandini, D. Bunjes, E. Carreras, A. Devergie, F. Frassoni, J. Goldman, et al.
Risk assessment in patients with Ph+ chronic myelogenous leukemia at first relapse after allogeneic stem cell transplant: an EBMT retrospective analysis
Blood,
June 1, 2000;
95(11):
3328 - 3334.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
N.C. Munshi, R. Govindarajan, R. Drake, L.M. Ding, R. Iyer, R. Saylors, J. Kornbluth, S. Marcus, Y. Chiang, D. Ennist, et al.
Thymidine Kinase (TK) Gene-Transduced Human Lymphocytes Can Be Highly Purified, Remain Fully Functional, and Are Killed Efficiently With Ganciclovir
Blood,
February 15, 1997;
89(4):
1334 - 1340.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S.-B. Woo, S. J. Lee, and M. M. Schubert
Graft-vs.-Host Disease
Critical Reviews in Oral Biology & Medicine,
January 1, 1997;
8(2):
201 - 216.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
