Long-term results after allogeneic bone marrow transplantation for chronic myelogenous leukemia in chronic phase: a report from the Chronic Leukemia Working Party of the European Group for Blood and Marrow Transplantation

被引:112
作者
vanRhee, F
Szydlo, RM
Hermans, J
Devergie, A
Frassoni, F
Arcese, W
deWitte, T
Kolb, HJ
Niederwiser, D
Jacobsen, N
Gahrton, G
Bandini, G
Carreras, E
Bacigalupo, A
Michallet, M
Ruutu, T
Reiffers, J
Goldman, JM
Apperley, J
Gratwohl, A
机构
[1] Hematology Branch, Building 10, National Institutes of Health, Bethesda, MD 208920-1652
关键词
CML; BMT; long-term outcome;
D O I
10.1038/sj.bmt.1700933
中图分类号
Q6 [生物物理学];
学科分类号
071011 ;
摘要
The purpose of this study was to determine the long-term results of allogeneic bone marrow transplantation for chronic myeloid leukemia. A retrospective analysis was carried out of the outcome of 373 consecutive transplants performed at 38 European institutions between 1980 and 1988 and reported to the registry of the European Group for Blood and Marrow Transplantation. All transplants were carried out for first chronic phase of chronic myelogenous leukemia using unmanipulated marow cells from HLA-identical sibling donors. The probability of survival and leukemia-free survival at 8 years were 54% (95% CI: 49-59) and 47% (95% CI: 41-52) respectively. The probabilities of developing acute GVHD (II-IV) at 100 days and chronic GVHD at 4 years after transplant were 47% (95% CI: 41-53) and 52% (95% CI: 46-58) respectively. The probabilities of transplant-related mortality and leukemic relapse 8 years after BMT were 41% (95% CI: 36-48) and 19% (95% CI: 14-25), respectively. Transplant within 12 months of diagnosis was associated with reduced transplant-related mortality (34 vs 45%, P = 0.013) and resulted in improved leukemia-free survival (52 vs 44%, P = 0.03). The probability of relapse was significantly reduced in patients who developed chronic GVHD (RR = 0.33, P = 0.004). The probability of relapse occurring more than 2 years after transplant was increased more than five-fold in patients transplanted from a male donor (RR = 5.5, P = 0.006). Sixty-seven patients in hematologic remission were studied for residual disease by two-step RT/PCR for BCR-ABL mRNA and 61 (91%) tested negative. We conclude that bone marrow transplantation can induce long-term survival in approximately one-half of CML patients; the majority of survivors have no evidence of residual leukemia cells when studied by molecular techniques. The probability of late relapse is increased with use of a male donor.
引用
收藏
页码:553 / 560
页数:8
相关论文
共 25 条
  • [1] UK MEDICAL-RESEARCH-COUNCIL RANDOMIZED, MULTICENTER TRIAL OF INTERFERON-ALPHA-N1 FOR CHRONIC MYELOID-LEUKEMIA - IMPROVED SURVIVAL IRRESPECTIVE OF CYTOGENETIC RESPONSE
    ALLAN, NC
    RICHARDS, SM
    SHEPHERD, PCA
    [J]. LANCET, 1995, 345 (8962) : 1392 - 1397
  • [2] BIERNAUX C, 1995, BLOOD, V86, P3118
  • [3] CLIFT RA, 1993, BLOOD, V82, P1954
  • [4] MINIMAL RESIDUAL DISEASE AFTER ALLOGENEIC BONE-MARROW TRANSPLANTATION FOR CHRONIC MYELOID-LEUKEMIA IN 1ST CHRONIC PHASE - CORRELATIONS WITH ACUTE GRAFT-VERSUS-HOST DISEASE AND RELAPSE
    CROSS, NCP
    HUGHES, TP
    FENG, L
    OSHEA, P
    BUNGEY, J
    MARKS, DI
    FERRANT, A
    MARTIAT, P
    GOLDMAN, JM
    [J]. BRITISH JOURNAL OF HAEMATOLOGY, 1993, 84 (01) : 67 - 74
  • [5] DROBYSKI WR, 1993, BLOOD, V82, P2310
  • [6] Relapse after non-T-cell-depleted allogeneic bone marrow transplantation for chronic myelogenous leukemia: Early transplantation use of an unrelated donor, and chronic graft-versus-host disease are protective
    Enright, H
    Davies, SM
    DeFor, T
    Shu, X
    Weisdorf, D
    Miller, W
    Ramsay, NKC
    Arthur, D
    Verfaillie, C
    Miller, J
    Kersey, J
    McGlave, P
    [J]. BLOOD, 1996, 88 (02) : 714 - 720
  • [7] FORMAN SJ, 1994, BLOOD, V83, P2392
  • [8] GOLDMAN JM, 1993, BLOOD, V82, P2235
  • [9] BONE-MARROW TRANSPLANTATION FOR CHRONIC MYELOGENOUS LEUKEMIA IN CHRONIC PHASE - INCREASED RISK FOR RELAPSE ASSOCIATED WITH T-CELL DEPLETION
    GOLDMAN, JM
    GALE, RP
    HOROWITZ, MM
    BIGGS, JC
    CHAMPLIN, RE
    GLUCKMAN, E
    HOFFMANN, RG
    JACOBSEN, SJ
    MARMONT, AM
    MCGLAVE, PB
    MESSNER, HA
    RIMM, AA
    ROZMAN, C
    SPECK, B
    TURA, S
    WEINER, RS
    BORTIN, MM
    [J]. ANNALS OF INTERNAL MEDICINE, 1988, 108 (06) : 806 - 814
  • [10] BONE-MARROW TRANSPLANTATION FOR PATIENTS WITH CHRONIC MYELOID-LEUKEMIA
    GOLDMAN, JM
    APPERLEY, JF
    JONES, L
    MARCUS, R
    GOOLDEN, AWG
    BATCHELOR, R
    HALE, G
    WALDMANN, H
    REID, CD
    HOWS, J
    GORDONSMITH, E
    CATOVSKY, D
    GALTON, DAG
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1986, 314 (04) : 202 - 207