Source:http://linkedlifedata.com/resource/pubmed/id/10617242
Switch to
Predicate | Object |
---|---|
rdf:type | |
lifeskim:mentions | |
pubmed:issue |
6
|
pubmed:dateCreated |
2000-1-19
|
pubmed:abstractText |
To minimize immunosuppression, allow a graft-versus-leukemia (GVL) effect, and reduce relapse incidence, 73 leukemic recipients of human leukocyte antigens-identical sibling marrow were given graft-versus-host disease (GVHD) prophylaxis based on the estimated risk of GVHD development. Methotrexate (MTX) monotherapy was given to patients with an estimated low risk of developing GVHD, whereas MTX + cyclosporine (CsA) was given to 'high-risk' patients. After engraftment, CsA was discontinued, and weekly MTX was reinstituted and given until 3 months post-bone marrow transplant. Conditioning consisted of busulfan (BU) + cyclophosphamide (CY) (n = 35) or CY + total body irradiation (TBI) (n = 38). Retrospective controls were given CY + TBI and MTX + CsA (n = 39). The median observation time was 5 yr 11 months. Chronic GVHD increased to 53% in the individual BU + CY group and 46% in the individual CY + TBI group, compared to 25% in the control group (p = 0.05). This increase was restricted to the limited form. The actuarial relapse incidence decreased to 20% in the individual BU + CY group, compared to 52% in the control group, p = 0.03. In the individual CY + TBI group, the relapse incidence was 44% (n.s. versus controls, p = 0.04 versus individual BU + CY). The 5-yr relapse-free survival (RFS) in the individual BU + CY group was 66%, in the control group, 41% (p = 0.07), and in the individual CY + TBI group, 45% (p = 0.1 versus individual BU + CY). Patients with early leukemia in the individual BU + CY group had a RFS of 83%, compared to 44% in the control group (p = 0.02) and 42% in the individual CY + TBI group (p = 0.01). In the multivariate analysis, advanced leukemia beyond first complete remission and first chronic phase and conditioning with CY + TBI were correlated to poor RFS. In summary, the individualized prophylaxis itself did not reduce the relapse incidence. However, in patients with early leukemia conditioning with BU + CY, our method of individualizing the GVHD prophylaxis might be of value, since this group had the best RFS in this study.
|
pubmed:language |
eng
|
pubmed:journal | |
pubmed:citationSubset |
IM
|
pubmed:chemical | |
pubmed:status |
MEDLINE
|
pubmed:month |
Dec
|
pubmed:issn |
0902-0063
|
pubmed:author | |
pubmed:issnType |
Print
|
pubmed:volume |
13
|
pubmed:owner |
NLM
|
pubmed:authorsComplete |
Y
|
pubmed:pagination |
512-9
|
pubmed:dateRevised |
2006-11-15
|
pubmed:meshHeading |
pubmed-meshheading:10617242-Aged,
pubmed-meshheading:10617242-Aged, 80 and over,
pubmed-meshheading:10617242-Bone Marrow Transplantation,
pubmed-meshheading:10617242-Busulfan,
pubmed-meshheading:10617242-Cyclophosphamide,
pubmed-meshheading:10617242-Disease-Free Survival,
pubmed-meshheading:10617242-Female,
pubmed-meshheading:10617242-Follow-Up Studies,
pubmed-meshheading:10617242-Graft vs Host Disease,
pubmed-meshheading:10617242-Humans,
pubmed-meshheading:10617242-Immunosuppressive Agents,
pubmed-meshheading:10617242-Leukemia,
pubmed-meshheading:10617242-Male,
pubmed-meshheading:10617242-Middle Aged,
pubmed-meshheading:10617242-Recurrence,
pubmed-meshheading:10617242-Survival Rate,
pubmed-meshheading:10617242-Time Factors
|
pubmed:year |
1999
|
pubmed:articleTitle |
Improved survival after bone marrow transplantation for early leukemia using busulfan-cyclophosphamide and individualized prophylaxis against graft-versus-host disease: a long-term follow-up.
|
pubmed:affiliation |
Centre for Allogeneic Stem Cell Transplantation, Department of Hematology, Huddinge Hospital, Stockholm, Sweden. johan.aschan@hematol.hs.sll.se
|
pubmed:publicationType |
Journal Article,
Clinical Trial,
Research Support, Non-U.S. Gov't
|