Second allogeneic transplant for leukemia relapsed after first allogeneic transplantation / 中华血液学杂志
Chinese Journal of Hematology
; (12): 285-289, 2004.
Article
de Zh
| WPRIM
| ID: wpr-291447
Bibliothèque responsable:
WPRO
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the efficacy of second allogeneic hematopoietic stem cell transplantation (allo-HSCT) for treatment of leukemia relapsed after first allo-HSCT.</p><p><b>METHODS</b>Nine patients with relapsed acute leukemia (5 AML, 4 ALL) and one with chronic myelogenous leukemia (CML) who showed cytogenetic relapse after first allo-HSCT received second allo-HSCT. The median relapse time from the first allo-HSCT was 141 days. Conditioning regimens for second allo-HSCT were combination chemotherapy based on moderate-dose Ara-C (n = 5), Bu (n = 3), conventional-dose Ara-C (n = 1) and Flud/Mel (n = 1). Prophylaxis for acute graft-versus-host disease (aGVHD) were CsA alone (n = 2), CsA/MTX (n = 1), FK506 (n = 1), and no prophylaxis in 6. The median number of peripheral blood mononuclear cells transfused was 6.1 x 10(8)/kg.</p><p><b>RESULTS</b>Eight cases were evaluable. All of them were engrafted and 7 developed aGVHD (grade I 4, grade II 3). The median time for absolute neutrophil count (ANC) > 0.5 x 10(9)/L and platelets > 20 x 10(9)/L were 11 and 12 days, respectively. Five cases developed localized chronic GVHD. Of all the 10 cases received second allo-HSCT, 8 died from interstitial pneumonia (n = 2), multiple-organ failure (n = 1), sepsis (n = 1), fungous pneumonia (n = 1), and leukemia relapse (n = 3), and 2 survived without leukemia for +986 and +1913 days, respectively. The leukemia free survival, transplantation related mortality and relapse rate at 2 year were 20%, 50% and 30%, respectively.</p><p><b>CONCLUSION</b>Second allo-HSCT is a therapeutic alternative for selected patients with relapsed leukemia after first allo-HSCT.</p>
Texte intégral:
1
Indice:
WPRIM
Sujet Principal:
Anatomopathologie
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Chirurgie générale
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Transplantation homologue
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Leucémies
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Études rétrospectives
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Résultat thérapeutique
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Transplantation de cellules souches hématopoïétiques
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Survie sans rechute
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Conditionnement pour greffe
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Maladie du greffon contre l'hôte
Type d'étude:
Observational_studies
Limites du sujet:
Adult
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Female
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Humans
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Male
langue:
Zh
Texte intégral:
Chinese Journal of Hematology
Année:
2004
Type:
Article