Document Detail


Fractionated TBI correlates with less T cell mixed chimerism but increased risk of relapse compared to busulphan in patients with haematological malignancies after allogeneic stem cell transplantation.
MedLine Citation:
PMID:  12942093     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We prospectively evaluated mixed chimerism (MC) in the T cell and myeloid lineages and its correlation to busulphan, single-dose total body irradiation (TBI) and fractionated TBI (fTBI) conditioning in 180 patients with haematological malignancies after allogeneic stem cell transplantation (SCT). In all patients receiving busulphan, the area under curve (AUC) was calculated. The incidence of MC in the T cell lineage was significantly lower in patients receiving fTBI (22%) compared to those given TBI (53%, P=0.02) or busulphan (47%, P<0.01). The incidence of myeloid MC did not differ between the three groups. The overall probability of acute graft-versus-host disease grades II-IV was significantly higher in patients with complete T cell donor chimerism (49%) compared to patients with T cell MC (23%, P<0.001). The incidence of T cell and myeloid MC after SCT did not differ between low (55%), medium (42%) and high (43%) AUC levels of busulphan during conditioning. Patients receiving fTBI had a significantly higher probability of relapse compared to busulphan-treated patients (44 vs l6%, P=0.01). In multivariate analysis adjusted for diagnosis, busulphan-treated patients showed both a better survival (P=0.04) and less probability of relapse (0.03) compared to TBI-treated patients.
Authors:
J Mattsson; M Uzunel; M Remberger; M Hassan
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Bone marrow transplantation     Volume:  32     ISSN:  0268-3369     ISO Abbreviation:  Bone Marrow Transplant.     Publication Date:  2003 Sep 
Date Detail:
Created Date:  2003-08-27     Completed Date:  2004-04-30     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8702459     Medline TA:  Bone Marrow Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  477-83     Citation Subset:  IM    
Affiliation:
Centre for Allogeneic Stem Cell Transplantation, Karolinska Institutet at Huddinge University Hospital, Stockholm, Sweden.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Busulfan / administration & dosage*,  pharmacokinetics
Cell Lineage
Child
Child, Preschool
Dose Fractionation
Female
Graft vs Host Disease / etiology
Hematologic Neoplasms / complications,  mortality,  therapy*
Hematopoietic Stem Cell Transplantation / adverse effects,  methods,  mortality
Humans
Infant
Male
Middle Aged
Multivariate Analysis
Myeloid Cells
Prospective Studies
Recurrence
Survival Analysis
T-Lymphocytes
Transplantation Chimera / immunology*
Transplantation Conditioning / adverse effects,  methods*,  mortality
Transplantation, Homologous
Whole-Body Irradiation*
Chemical
Reg. No./Substance:
55-98-1/Busulfan

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