Source:http://linkedlifedata.com/resource/pubmed/id/12750695
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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
5
|
| pubmed:dateCreated |
2003-5-16
|
| pubmed:abstractText |
Allogeneic stem cell transplantation (SCT) using reduced-intensity conditioning (RIC) has potential to be a promising treatment of aggressive chronic lymphocytic leukemia (CLL). Since available clinical data obtained with this novel approach are very limited, we have performed a survey on this issue. Data of 77 patients were collected from 29 European Group for Blood and Marrow Transplantation centers. Median age was 54 (30-66) years, and the median number of previous chemotherapy regimens was 3 (0-8). HLA-identical sibling donors were used in 81% of the cases. Moderate conditioning regimens (mainly low-dose total body irradiation (TBI) or fludarabine-cyclophosphamide combinations) were administered to 56% of the patients, whereas the remainder received more intense conditioning consisting of fludarabine-busulfan or high-dose melphalan combinations. In 40% of the patients, in vivo T-cell depletion (TCD) with anti-thymocyte globulin or CAMPATH-1H was part of the conditioning regimen. Cumulative treatment-related mortality (TRM) was 18% (95% CI 9; 27) after 12 months. Complete chimerism as well as best response was not achieved immediately post-transplant but took a median of 3 months to develop. The 2-year probability of relapse was 31% (95% CI 18; 44), with no event occurring later than 12 months post transplant in the absence of TCD. With one exception, relapses were not observed after onset of chronic graft-versus-host disease. Event-free and overall survival at 24 months were 56% (95% CI 43; 69) and 72% (95% CI 61; 83), respectively. The median follow-up was 18 (1-44) months. Donor lymphocyte infusions or secondary transplants were performed in 19 patients with insufficient disease control and/or incomplete donor chimerism post-transplant, leading to a response in seven patients (37%). Preliminary multivariate analysis identified less than PR at transplant (hazard ratio (HR) 3.5; P&<0.01) and alternative donor (HR 3.1; P=0.02) as significant risk factors for relapse, whereas number of previous regimens >2 (HR 5.4; P=0.03), TBI (HR 2.5; P=0.05), and alternative donor (HR 2.3; P=0.08) were risk factors for survival. We conclude that RIC might favorably influence the outcome after allogeneic SCT for CLL by reducing TRM while preserving graft-versus leukemia activity.
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| pubmed:language |
eng
|
| pubmed:journal | |
| pubmed:citationSubset |
IM
|
| pubmed:chemical | |
| pubmed:status |
MEDLINE
|
| pubmed:month |
May
|
| pubmed:issn |
0887-6924
|
| pubmed:author |
pubmed-author:BrandRR,
pubmed-author:Chronic Leukemia Working Party of the EBMT,
pubmed-author:CorradiniPP,
pubmed-author:DeliliersG LGL,
pubmed-author:DregerPP,
pubmed-author:FinkeJJ,
pubmed-author:HanszJJ,
pubmed-author:MartinoRR,
pubmed-author:MichalletMM,
pubmed-author:MilliganDD,
pubmed-author:NiederwieserDD,
pubmed-author:RussellNN,
pubmed-author:Van BiezenAA
|
| pubmed:issnType |
Print
|
| pubmed:volume |
17
|
| pubmed:owner |
NLM
|
| pubmed:authorsComplete |
Y
|
| pubmed:pagination |
841-8
|
| pubmed:dateRevised |
2007-11-15
|
| pubmed:meshHeading |
pubmed-meshheading:12750695-Adult,
pubmed-meshheading:12750695-Aged,
pubmed-meshheading:12750695-Antineoplastic Combined Chemotherapy Protocols,
pubmed-meshheading:12750695-Busulfan,
pubmed-meshheading:12750695-Cohort Studies,
pubmed-meshheading:12750695-Disease-Free Survival,
pubmed-meshheading:12750695-Female,
pubmed-meshheading:12750695-Graft vs Host Disease,
pubmed-meshheading:12750695-Hematopoietic Stem Cell Transplantation,
pubmed-meshheading:12750695-Humans,
pubmed-meshheading:12750695-Leukemia, Lymphocytic, Chronic, B-Cell,
pubmed-meshheading:12750695-Lymphocyte Depletion,
pubmed-meshheading:12750695-Male,
pubmed-meshheading:12750695-Middle Aged,
pubmed-meshheading:12750695-Neoplasm Recurrence, Local,
pubmed-meshheading:12750695-Neoplasm Staging,
pubmed-meshheading:12750695-Remission Induction,
pubmed-meshheading:12750695-Retrospective Studies,
pubmed-meshheading:12750695-Survival Rate,
pubmed-meshheading:12750695-Transplantation, Homologous,
pubmed-meshheading:12750695-Transplantation Conditioning,
pubmed-meshheading:12750695-Treatment Outcome,
pubmed-meshheading:12750695-Vidarabine,
pubmed-meshheading:12750695-Whole-Body Irradiation
|
| pubmed:year |
2003
|
| pubmed:articleTitle |
Treatment-related mortality and graft-versus-leukemia activity after allogeneic stem cell transplantation for chronic lymphocytic leukemia using intensity-reduced conditioning.
|
| pubmed:affiliation |
Department of Hematology, Allgemeines Krankenhaus St Georg, Hamburg, Germany.
|
| pubmed:publicationType |
Journal Article,
Review,
Research Support, Non-U.S. Gov't,
Multicenter Study
|