Document Detail


Reduced intensity conditioning for allogeneic hematopoietic stem cell transplantation in patients with acute myeloid leukemia: disease status by marrow blasts is the strongest prognostic factor.
MedLine Citation:
PMID:  12796788     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We analyzed predictive factors for the outcome of 113 acute myeloid leukemia patients receiving reduced-intensity conditioning prior to allogeneic hematopoietic stem cell transplantation (HSCT). Patients were ineligible for conventional-intensity HSCT. Conditioning consisted of fludarabine and 50% of the conventional dose of busulfan (n=93) or total body irradiation (n=20). The source of stem cells was blood in 102 patients, marrow in 10, and both in one. In total, 50 (44.2%) donors were HLA-matched siblings, 50 (44.2%) unrelated fully matched and 13 (11.5%) partially mismatched family (n=1) or unrelated (n=12) donors. In all, 107 (94.6%) patients showed neutrophil and platelet engraftment after a median time of 13.5 and 13 days. The probabilities of event-free survival (EFS) (median follow-up: 12 months) were 49% for patients with less than 5% blasts in the marrow, 24% for patients with 5-20% blasts (P=0.002) and 14% with >20% blasts (P<or=0.001). Death occurred because of relapse in 29 patients (25.6%), infection in 12 patients (10.6%), acute graft-versus-host disease in eight patients (7.0%) and organ toxicity in nine patients (7.9%). In multivariate analysis, higher number of blasts in the marrow, alternative donors and low Karnofsky performance score were independent adverse prognostic factors for EFS.
Authors:
H G Sayer; M Kröger; J Beyer; M Kiehl; S A Klein; K Schaefer-Eckart; R Schwerdtfeger; W Siegert; V Runde; C Theuser; H Martin; J Schetelig; D W Beelen; A Fauser; J Kienast; K Höffken; G Ehninger; M Bornhäuser;
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Bone marrow transplantation     Volume:  31     ISSN:  0268-3369     ISO Abbreviation:  Bone Marrow Transplant.     Publication Date:  2003 Jun 
Date Detail:
Created Date:  2003-06-10     Completed Date:  2004-03-01     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8702459     Medline TA:  Bone Marrow Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  1089-95     Citation Subset:  IM    
Affiliation:
Klinik und Poliklinik für Innere Medizin II, Friedrich-Schiller-Universität Jena, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Female
Germany / epidemiology
Graft Survival
Graft vs Host Disease / etiology
Hematopoietic Stem Cell Transplantation* / adverse effects
Humans
Leukemia, Myeloid, Acute / mortality,  pathology,  therapy*
Male
Middle Aged
Prognosis
Retrospective Studies
Survival Rate
Transplantation Conditioning / adverse effects,  methods*
Transplantation, Homologous

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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