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Allogeneic stem-cell transplantation in patients with refractory acute leukemia: a long-term follow-up.
Bone Marrow Transplant. 2006 Jan; 37(1):45-50.BM

Abstract

We examined retrospectively 44 patients with refractory acute leukemia (acute myeloid leukemia (AML)/acute lymphoblastic leukemia=25/19) who underwent allogeneic transplantation at our center between 11/1990 and 04/2004. The median leukemic blasts was 25% and age 28 years (range, 3-56). Twenty-one patients had untreated relapse, 13 failed reinduction, eight in partial remission and two aplastic. Conditioning was myeloablative using cyclophosphamide, busulfan, total-body irradiation and etoposide (Bu/Cy/VP, n=22; TBI/Cy/VP, n=17; others, n=5) followed by marrow or peripheral blood transplant (n=23/21) from unrelated or related donors (n=28/16). All patients had graft-versus-host disease (GVHD) prophylaxis with cyclosporin and methotrexate. One patient experienced late graft failure. Severe acute-GVHD and chronic-GVHD appeared in eight and 14 patients, respectively. Thirteen patients (30%) remain alive after a median of 25.3 months (range, 2.4-134.1); with 31 deaths, mostly from relapse (n=15) and infections (n=12). Overall survival (OS) and progression-free survival (PFS) at 5 years was 28 and 26%, respectively. OS and PFS were significantly better with blasts < or =20% and time to transplant < or =1 year while transplant-related mortality was less with the use of TBI. We conclude that patients with refractory leukemia can benefit from allogeneic BMT, especially with < or =20% marrow blast.

Authors+Show Affiliations

Department of Bone Marrow Transplantation, University-Hospital Hamburg-Eppendorf, Hamburg, Germany. oyekunleaa@yahoo.co.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16258531

Citation

Oyekunle, A A., et al. "Allogeneic Stem-cell Transplantation in Patients With Refractory Acute Leukemia: a Long-term Follow-up." Bone Marrow Transplantation, vol. 37, no. 1, 2006, pp. 45-50.
Oyekunle AA, Kröger N, Zabelina T, et al. Allogeneic stem-cell transplantation in patients with refractory acute leukemia: a long-term follow-up. Bone Marrow Transplant. 2006;37(1):45-50.
Oyekunle, A. A., Kröger, N., Zabelina, T., Ayuk, F., Schieder, H., Renges, H., Fehse, N., Waschke, O., Fehse, B., Kabisch, H., & Zander, A. R. (2006). Allogeneic stem-cell transplantation in patients with refractory acute leukemia: a long-term follow-up. Bone Marrow Transplantation, 37(1), 45-50.
Oyekunle AA, et al. Allogeneic Stem-cell Transplantation in Patients With Refractory Acute Leukemia: a Long-term Follow-up. Bone Marrow Transplant. 2006;37(1):45-50. PubMed PMID: 16258531.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Allogeneic stem-cell transplantation in patients with refractory acute leukemia: a long-term follow-up. AU - Oyekunle,A A, AU - Kröger,N, AU - Zabelina,T, AU - Ayuk,F, AU - Schieder,H, AU - Renges,H, AU - Fehse,N, AU - Waschke,O, AU - Fehse,B, AU - Kabisch,H, AU - Zander,A R, PY - 2005/11/1/pubmed PY - 2006/4/6/medline PY - 2005/11/1/entrez SP - 45 EP - 50 JF - Bone marrow transplantation JO - Bone Marrow Transplant VL - 37 IS - 1 N2 - We examined retrospectively 44 patients with refractory acute leukemia (acute myeloid leukemia (AML)/acute lymphoblastic leukemia=25/19) who underwent allogeneic transplantation at our center between 11/1990 and 04/2004. The median leukemic blasts was 25% and age 28 years (range, 3-56). Twenty-one patients had untreated relapse, 13 failed reinduction, eight in partial remission and two aplastic. Conditioning was myeloablative using cyclophosphamide, busulfan, total-body irradiation and etoposide (Bu/Cy/VP, n=22; TBI/Cy/VP, n=17; others, n=5) followed by marrow or peripheral blood transplant (n=23/21) from unrelated or related donors (n=28/16). All patients had graft-versus-host disease (GVHD) prophylaxis with cyclosporin and methotrexate. One patient experienced late graft failure. Severe acute-GVHD and chronic-GVHD appeared in eight and 14 patients, respectively. Thirteen patients (30%) remain alive after a median of 25.3 months (range, 2.4-134.1); with 31 deaths, mostly from relapse (n=15) and infections (n=12). Overall survival (OS) and progression-free survival (PFS) at 5 years was 28 and 26%, respectively. OS and PFS were significantly better with blasts < or =20% and time to transplant < or =1 year while transplant-related mortality was less with the use of TBI. We conclude that patients with refractory leukemia can benefit from allogeneic BMT, especially with < or =20% marrow blast. SN - 0268-3369 UR - https://www.unboundmedicine.com/medline/citation/16258531/Allogeneic_stem_cell_transplantation_in_patients_with_refractory_acute_leukemia:_a_long_term_follow_up_ L2 - https://doi.org/10.1038/sj.bmt.1705207 DB - PRIME DP - Unbound Medicine ER -