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[Effects and prognostic factors of HLA-matched sibling donor allogeneic hematopoietic stem cell transplantation for chronic myelogenous leukemia].
Zhonghua Zhong Liu Za Zhi. 2006 Jul; 28(7):545-8.ZZ

Abstract

OBJECTIVE

To retrospectively analyze the curative effects and prognostic factors of HLA-matched sibling donor allogeneic hematopoietic stem cell transplantation (allo-HSCT) for chronic myelogenous leukemia patients (CML).

METHODS

Of the 35 CML patients, 26 were males and 9 were females, with a median age of 32 (12 - 50) years. 30 patients were in chronic phase of CML, 5 patients were in accelerated phase. Allo-HSCT from HLA identical siblings was performed for 35 patients, of whom 11 received bone marrow transplantation (BMT) and 24 peripheral blood stem cell transplantation (PBSCT). Conditioning regimens was TBI (total-body irradiation) + CY (CTX) protocol in 8 patients and BU/CY protocol in 27 patients. The average follow-up was 48 months (range 7 - 108 months).

RESULTS

34 (97.1%) patients were successfully engrafted. Among them, 21 patients (60.0%) had three years disease-free (DFS) survival. The overall 5-year survival (OS) was 57.1%. Two patients (5.7%) relapsed. Transplant-related mortality occurred in 12 patients. Hemorrhagic cystitis (HC) occurred in 5 patients and HVOD was observed in 1 patient. Acute graft-versus-host disease (aGVHD) occurred in 18 patients (51.4%), among them 7 patients (20.0%) were of grade III-IV. Chronic GVHD was in 17 patients (48.5%). There was no significant difference in 3-years DFS between BMT group and PBSCT group (54.5% vs. 62.5%, P > 0.05). The 3-year disease-free survival (DFS) was 42.9% in TBI/CY group and 55.6% in BU/CY group (P > 0.05). In univariate prognostic analysis model, the DFS at 3 years is 75% and 47.4% for < or =30 years patients and >30 years patients, respectively, P < 0.05. The 3-year DFS of patients with first chronic phase is higher than patients with advanced diseases (61.3% vs. 40%, P < 0. 05). The 3-year DFS in patients of grade I - II GVHD was higher than that in patients of grade III-IV GVHD (81.8% vs. 14.3%, P < 0.05).

CONCLUSION

The patients who had transplantation done within 1 year after diagnosis during their first chronic phase of disease and who had low-grade GVHD have better prognosis. Those patients who had III-IV acute GVHD are prone to incorporate severe infection, which was a worse prognostic factor of allo-HSCT for chronic myelogenous leukemia.

Authors+Show Affiliations

Department of Hematology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China. Tongxz05@163.comNo 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)

Clinical Trial
English Abstract
Journal Article

Language

chi

PubMed ID

17147125

Citation

Tong, Xiu-Zhen, et al. "[Effects and Prognostic Factors of HLA-matched Sibling Donor Allogeneic Hematopoietic Stem Cell Transplantation for Chronic Myelogenous Leukemia]." Zhonghua Zhong Liu Za Zhi [Chinese Journal of Oncology], vol. 28, no. 7, 2006, pp. 545-8.
Tong XZ, Li J, Tan EX, et al. [Effects and prognostic factors of HLA-matched sibling donor allogeneic hematopoietic stem cell transplantation for chronic myelogenous leukemia]. Zhonghua Zhong Liu Za Zhi. 2006;28(7):545-8.
Tong, X. Z., Li, J., Tan, E. X., Zhang, G. C., Wu, X. Y., Peng, A. H., Zheng, D., Zou, W. Y., Hong, W. D., & Luo, S. K. (2006). [Effects and prognostic factors of HLA-matched sibling donor allogeneic hematopoietic stem cell transplantation for chronic myelogenous leukemia]. Zhonghua Zhong Liu Za Zhi [Chinese Journal of Oncology], 28(7), 545-8.
Tong XZ, et al. [Effects and Prognostic Factors of HLA-matched Sibling Donor Allogeneic Hematopoietic Stem Cell Transplantation for Chronic Myelogenous Leukemia]. Zhonghua Zhong Liu Za Zhi. 2006;28(7):545-8. PubMed PMID: 17147125.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Effects and prognostic factors of HLA-matched sibling donor allogeneic hematopoietic stem cell transplantation for chronic myelogenous leukemia]. AU - Tong,Xiu-Zhen, AU - Li,Juan, AU - Tan,En-Xun, AU - Zhang,Guo-Cai, AU - Wu,Xiang-Yuan, AU - Peng,Ai-Hua, AU - Zheng,Dong, AU - Zou,Wai-Yi, AU - Hong,Wen-De, AU - Luo,Shao-Kai, PY - 2006/12/7/pubmed PY - 2008/2/15/medline PY - 2006/12/7/entrez SP - 545 EP - 8 JF - Zhonghua zhong liu za zhi [Chinese journal of oncology] JO - Zhonghua Zhong Liu Za Zhi VL - 28 IS - 7 N2 - OBJECTIVE: To retrospectively analyze the curative effects and prognostic factors of HLA-matched sibling donor allogeneic hematopoietic stem cell transplantation (allo-HSCT) for chronic myelogenous leukemia patients (CML). METHODS: Of the 35 CML patients, 26 were males and 9 were females, with a median age of 32 (12 - 50) years. 30 patients were in chronic phase of CML, 5 patients were in accelerated phase. Allo-HSCT from HLA identical siblings was performed for 35 patients, of whom 11 received bone marrow transplantation (BMT) and 24 peripheral blood stem cell transplantation (PBSCT). Conditioning regimens was TBI (total-body irradiation) + CY (CTX) protocol in 8 patients and BU/CY protocol in 27 patients. The average follow-up was 48 months (range 7 - 108 months). RESULTS: 34 (97.1%) patients were successfully engrafted. Among them, 21 patients (60.0%) had three years disease-free (DFS) survival. The overall 5-year survival (OS) was 57.1%. Two patients (5.7%) relapsed. Transplant-related mortality occurred in 12 patients. Hemorrhagic cystitis (HC) occurred in 5 patients and HVOD was observed in 1 patient. Acute graft-versus-host disease (aGVHD) occurred in 18 patients (51.4%), among them 7 patients (20.0%) were of grade III-IV. Chronic GVHD was in 17 patients (48.5%). There was no significant difference in 3-years DFS between BMT group and PBSCT group (54.5% vs. 62.5%, P > 0.05). The 3-year disease-free survival (DFS) was 42.9% in TBI/CY group and 55.6% in BU/CY group (P > 0.05). In univariate prognostic analysis model, the DFS at 3 years is 75% and 47.4% for < or =30 years patients and >30 years patients, respectively, P < 0.05. The 3-year DFS of patients with first chronic phase is higher than patients with advanced diseases (61.3% vs. 40%, P < 0. 05). The 3-year DFS in patients of grade I - II GVHD was higher than that in patients of grade III-IV GVHD (81.8% vs. 14.3%, P < 0.05). CONCLUSION: The patients who had transplantation done within 1 year after diagnosis during their first chronic phase of disease and who had low-grade GVHD have better prognosis. Those patients who had III-IV acute GVHD are prone to incorporate severe infection, which was a worse prognostic factor of allo-HSCT for chronic myelogenous leukemia. SN - 0253-3766 UR - https://www.unboundmedicine.com/medline/citation/17147125/[Effects_and_prognostic_factors_of_HLA_matched_sibling_donor_allogeneic_hematopoietic_stem_cell_transplantation_for_chronic_myelogenous_leukemia]_ L2 - http://journal.yiigle.com/LinkIn.do?linkin_type=pubmed&amp;issn=0253-3766&amp;year=2006&amp;vol=28&amp;issue=7&amp;fpage=545 DB - PRIME DP - Unbound Medicine ER -