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- Title
Excellent disease eradication by myeloablative therapy and stem-cell transplantation in patients with acute myelogenous leukemia.
- Authors
Greinix, H. T.; Loidolt, H.; Rabitsch, W.; Schulenburg, A.; Keil, F.; Mitterbauer, M.; Laczika, K.; Lechner, K.; Dieckmann, K.; Fischer, G.; Jäger, U.; Rosenmayr, A.; Knöbl, P.; Schwarzinger, I.; Höcker, P.; Mannhalter, C.; Hinterberger, W.; Haas, O. A.; Fonatsch, C.; Kalhs, P.
- Abstract
Between February 1982 and 1999, 118 consecutive patients (65 male, 53 female) with acute myelogenous leukemia (AML), with a median age of 35 years (range 17-56 years), received stem-cell grafts from a human leukocyte antigen-identical sibling (n = 71), one-antigen-mismatched family member (n=2), matched unrelated donor (n=15), one-antigen-mismatched unrelated donor (n = 4) or an autologous (n = 26) graft. At the time of transplant, 56 patients were in the first complete remission (CR), 27 in the second CR, 6 in untreated relapse, 17 in primary refractory, and 12 in refractory relapse. The French-American-British classification (FAB) subtypes were as follows: M1 (n=25), M2 (n=28), M3 (n=11), M4 (n =32), M5 (n=16), M6 (n = 6). For conditioning, most patients underwent total body irradiation-containing regimens. As of 28 February, 1999, probability of leukemia-free survival (LFS) is 58% for patients after related and 45% after unrelated stem-cell transplantation (SCT). The probability of LFS is 70% for patients given allogeneic transplants in the first CR compared with 33% for those beyond the first CR at SCT. In autologous stem-cell graft recipients, the probability of LFS is 37%. Transplant-related mortality was 28% after related, 20% after unrelated, and 4% after autologous SCT. Probability of relapse for patients given related-donor stem-cell grafts in the first CR and beyond the first CR is 30% and 67%, 55% after unrelated and 63% after autologous stem-cell grafting. Thus, myeloablative therapy followed by allogeneic stem-cell infusion has a high curative potential for patients with AML in remission and offers substantial benefits to patients in advanced disease.
- Subjects
MYELOID leukemia; NONLYMPHOID leukemia; CELL transplantation; CELLULAR therapy; BONE marrow diseases; LEUKEMIA
- Publication
Annals of Hematology, 2000, Vol 79, Issue 4, p206
- ISSN
0939-5555
- Publication type
journal article
- DOI
10.1007/s002770050580