Allogeneic stem-cell transplantation in patients with refractory acute leukemia: a long-term follow-up.
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Allogeneic stem-cell transplantation in patients with refractory acute leukemia: a long-term follow-up. / Oyekunle, A A; Kröger, Nicolaus; Zabelina, Tatjana; Ayuketang Ayuk, Francis; Schieder, H; Renges, H; Fehse, N; Waschke, Olga; Fehse, Boris; Kabisch, H; Zander, Axel R.
in: BONE MARROW TRANSPL, Jahrgang 37, Nr. 1, 1, 2006, S. 45-50.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - Allogeneic stem-cell transplantation in patients with refractory acute leukemia: a long-term follow-up.
AU - Oyekunle, A A
AU - Kröger, Nicolaus
AU - Zabelina, Tatjana
AU - Ayuketang Ayuk, Francis
AU - Schieder, H
AU - Renges, H
AU - Fehse, N
AU - Waschke, Olga
AU - Fehse, Boris
AU - Kabisch, H
AU - Zander, Axel R.
PY - 2006
Y1 - 2006
N2 - We examined retrospectively 44 patients with refractory acute leukemia (acute myeloid leukemia (AML)/acute lymphoblastic leukemia=25/19) who underwent allogeneic transplantation at our center between 11/1990 and 04/2004. The median leukemic blasts was 25% and age 28 years (range, 3-56). Twenty-one patients had untreated relapse, 13 failed reinduction, eight in partial remission and two aplastic. Conditioning was myeloablative using cyclophosphamide, busulfan, total-body irradiation and etoposide (Bu/Cy/VP, n=22; TBI/Cy/VP, n=17; others, n=5) followed by marrow or peripheral blood transplant (n=23/21) from unrelated or related donors (n=28/16). All patients had graft-versus-host disease (GVHD) prophylaxis with cyclosporin and methotrexate. One patient experienced late graft failure. Severe acute-GVHD and chronic-GVHD appeared in eight and 14 patients, respectively. Thirteen patients (30%) remain alive after a median of 25.3 months (range, 2.4-134.1); with 31 deaths, mostly from relapse (n=15) and infections (n=12). Overall survival (OS) and progression-free survival (PFS) at 5 years was 28 and 26%, respectively. OS and PFS were significantly better with blasts <or =20% and time to transplant <or =1 year while transplant-related mortality was less with the use of TBI. We conclude that patients with refractory leukemia can benefit from allogeneic BMT, especially with <or =20% marrow blast.
AB - We examined retrospectively 44 patients with refractory acute leukemia (acute myeloid leukemia (AML)/acute lymphoblastic leukemia=25/19) who underwent allogeneic transplantation at our center between 11/1990 and 04/2004. The median leukemic blasts was 25% and age 28 years (range, 3-56). Twenty-one patients had untreated relapse, 13 failed reinduction, eight in partial remission and two aplastic. Conditioning was myeloablative using cyclophosphamide, busulfan, total-body irradiation and etoposide (Bu/Cy/VP, n=22; TBI/Cy/VP, n=17; others, n=5) followed by marrow or peripheral blood transplant (n=23/21) from unrelated or related donors (n=28/16). All patients had graft-versus-host disease (GVHD) prophylaxis with cyclosporin and methotrexate. One patient experienced late graft failure. Severe acute-GVHD and chronic-GVHD appeared in eight and 14 patients, respectively. Thirteen patients (30%) remain alive after a median of 25.3 months (range, 2.4-134.1); with 31 deaths, mostly from relapse (n=15) and infections (n=12). Overall survival (OS) and progression-free survival (PFS) at 5 years was 28 and 26%, respectively. OS and PFS were significantly better with blasts <or =20% and time to transplant <or =1 year while transplant-related mortality was less with the use of TBI. We conclude that patients with refractory leukemia can benefit from allogeneic BMT, especially with <or =20% marrow blast.
M3 - SCORING: Zeitschriftenaufsatz
VL - 37
SP - 45
EP - 50
JO - BONE MARROW TRANSPL
JF - BONE MARROW TRANSPL
SN - 0268-3369
IS - 1
M1 - 1
ER -