Bone marrow transplantation for acute leukemia in second or subsequent remission

Ostendorf, P.; Ehninger, Gerhard; Kallmayer, M. L.; Link, H.; Schüch, K.; Wilms, K.; Wernet, Peter; Döpfer, H.; Niethammer, D.; Frommhold, W; Hübener, K.-H.; Breitling, G.; Schneider, W; Waller, H. D.

doi:10.1007/bf01711377

Cited by 5 publications

(4 citation statements)

References 16 publications

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“…7,8 However, few studies reporting a large enough sample of patients to determine prognostic factors have been reported. [13][14][15][16][17] To our knowledge, this study is the largest cohort of patients with an advanced stage of AML undergoing allogeneic HSCT. We have shown that factors over which we have total, some, or no control can influence survival duration, risk of relapse and TRM after transplantation.…”

Section: Discussionmentioning

confidence: 99%

Long-term outcome after allogeneic hematopoietic stem cell transplantation for advanced stage acute myeloblastic leukemia: a retrospective study of 379 patients reported to the Société Française de Greffe de Moelle (SFGM)

Michallet

Thomas²,

Jp³

et al. 2000

Bone Marrow Transplant

145

101

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Summary:To assess the place of allogeneic hematopoietic stem cell transplantation (HSCT) in the advanced stage of acute myeloid leukemia (AML), we retrospectively analyzed 379 consecutive patients who underwent allogeneic HSCT for advanced AML. The median follow-up of the entire cohort was 7.5 years. Sixty-nine patients (18%) were transplanted with primary resistant disease. Three hundred and ten (82%) were relapsed patients, 94 (30%) of whom were in untreated relapse, 67 (22%) in refractory relapse and 149 (48%) in 2nd or 3rd complete remission at time of transplantation. The 5-year probabilities of overall survival (OS), disease-free survival (DFS), and transplant-related mortality (TRM) were 22 ؎ 4% 20 ؎ 4%, 45 ؎ 6%, respectively. In multivariate analysis, we demonstrated the favorable impact on OS, DFS and TRM of two factors over which we have no control (age Ͻ15 years, complete remission achievement) and three factors over which we have some control (female donor, acute and chronic graftversus-host disease). The results of this study suggest that the graft-versus-leukemia effect is important in advanced AML and that new HSCT modalities are needed for some patients with this indication. Bone Marrow Transplantation (2000) 26, 1157-1163. Keywords: allogeneic; HSCT; advanced; AML The outcome of treatment in younger patients with de novo acute myeloid leukemia (AML) has improved substantially over the past decade. Complete remission (CR) rates range from 60% to 80% with long-term survival in about 50% of

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Section: Discussionmentioning

confidence: 99%

Long-term outcome after allogeneic hematopoietic stem cell transplantation for advanced stage acute myeloblastic leukemia: a retrospective study of 379 patients reported to the Société Française de Greffe de Moelle (SFGM)

Michallet

Thomas²,

Jp³

et al. 2000

Bone Marrow Transplant

145

101

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“…Zus/itzlich wurde das Transplantat bei hinreichender Zellzahl (mehr als 2 x 10 s mononukle/ire Zetten/kg K6rpergewicht) mit Anti-Human-T-Zell-Globulin (AHTCG) vorinkubiert [64]. Bez/iglich der Einzelheiten und Dosierung wird auf die fr/iheren Berichte ve~Tiesen [56,87]. Ab KMT Nr.…”

Section: Gvhd-prophylaxe Und Therapieunclassified

“…38 wurden alte Patienten bei einem Alter gr613er als 10 Jahre prophylaktisch mit Cyclosporin A behandelt, die Applikation erfolgte intraven6s vom Tag -I 0 bis + 20, nachfolgend oral. Zu Einzetheiten der Cyclosporin A-Dosierung und Reduktion bei entsprechenden Nebenwirkungen wird auf den fr/iheren Bericht verwiesen [56]. Die Therapie einer akuten GvHD erfolgte nach einer Hautbiopsie mit Prednisolon in einer Dosierung von 1-2 mg/kg K6rpergewicht bei den klinischen Schweregraden I u n d II, bei Grad III und IV kurzfristig mit 10-20 mg/kg K6rpergewicht Prednisolon intraven6s.…”

Section: Gvhd-prophylaxe Und Therapieunclassified

“…The following 46 patients (BMT Die Knochenmarktransplantation ist ein anerkanntes Behandlungskonzept filr akute Leukfimien [77,90,15] chronisch myeloische Leuk/imien [25,69] und schwere aplastische An/imien [74,44]. Filr bestimmte Subgruppen akuter Leuk/imien ist dieses Therapiekonzept konventioneller intensiver Chemotherapie ilberlegen [18,7,67,56]. Bei Transplantation in 1. kompletter Remission milssen die Ergebnisse randomisierter Studien filr eine endgilltige Aussage noch abgewartet werden [12].…”

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Knochenmarktransplantation bei akuter Leukämie, chronisch myeloischer Leukämie, schwerer aplastischer Anämie und Neuroblastom Stadium IV. Einfluß antiviraler Prophylaxe mit Anti-CMV-Hyperimmunglobulin und Azyklovir

et al. 1986

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Bone marrow transplantation was performed between IV/82 and X/85 in 64 patients with acute leukemia (n = 36), chronic myelogenous leukemia (CML; n = 13), severe aplastic anemia (n = 12), and neuroblastoma stage IV (n = 3). Of these patients 57 received allogeneic marrow from HLA-ABCDR identical, MLC-negative sibling donors. Six transplants were performed with syngenic marrow and one with autologous marrow. Of the 64 patients 48 survived 40-1,250 days after transplantation, resulting in a survival rate (SR) of 75% and a survival probability (SP) of 71%. Of the 36 patients suffering from acute leukemia (SR = 64%, SP = 51%), patients with acute myelogenous leukemia (AML) in first complete remission (n = 11; SR = 81%, SP = 76%), as well as patients with acute lymphatic leukemia (ALL) in 1st to 4th complete remission at the time of transplantation (n = 14; SR = 81%, SP = 76%) show a favorable prognosis. A poor survival rate was seen for patients with AML when transplanted in second or partial remission (1/5; SR = 20%), as well as for patients suffering from ALL and transplanted during relapse or partial remission (1/6; SR = 16%). Of 13 patients suffering from CML 12 survived the transplantation free of relapse (SR = 93%, SP = 92%), and one patient died from varicella zoster pneumonia. Of the transplanted patients with severe aplastic anemia, 12 of 13 are surviving with complete hematologic reconstitution; one patient, however, died on day 10 from a sepsis. In our patient group, the SR as well as the SP has been improved through changes in the irradiation protocol concomitant with prophylactic application of anti-CMV hypergammaglobulin, as well as through additional oral medication of Azyklovir. The 41 patients (BMT No. 7-47) with total body irradiation at one time show an SR of 44% and an SP of 41%. The following 46 patients (BMT No. 48-93) have reached an SR of 83% and an SP of 74% under the regimen of fractionated total body irradiation, plus prophylaxis with anti-CMV hypergammaglobulin and Azyklovir. Within this group, no fatal CMV pneumonia was encountered as opposed to six patients lost from CMV pneumonia in the first group.

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Bone Marrow Transplantation in Childhood Leukemia in West Germany

et al. 1987

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Bone marrow transplantation for acute leukemia in second or subsequent remission

Cited by 5 publications

References 16 publications

Long-term outcome after allogeneic hematopoietic stem cell transplantation for advanced stage acute myeloblastic leukemia: a retrospective study of 379 patients reported to the Société Française de Greffe de Moelle (SFGM)

Long-term outcome after allogeneic hematopoietic stem cell transplantation for advanced stage acute myeloblastic leukemia: a retrospective study of 379 patients reported to the Société Française de Greffe de Moelle (SFGM)

Knochenmarktransplantation bei akuter Leukämie, chronisch myeloischer Leukämie, schwerer aplastischer Anämie und Neuroblastom Stadium IV. Einfluß antiviraler Prophylaxe mit Anti-CMV-Hyperimmunglobulin und Azyklovir

Bone Marrow Transplantation in Childhood Leukemia in West Germany

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