Allogeneic blood stem cell and bone marrow transplantation for acute myelogenous leukemia and myelodysplasia: influence of stem cell source on outcome

被引:37
作者
Russell, JA
Larratt, L
Brown, C
Turner, AR
Chaudhry, A
Booth, K
Woodman, RC
Wolff, J
Valentine, K
Stewart, D
Ruether, JD
Ruether, BA
Klassen, J
Jones, AR
Gyonyor, E
Egeler, M
Dunsmore, J
Desai, S
Coppes, MJ
Bowen, T
Anderson, R
Poon, MC
机构
[1] Tom Baker Canc Clin, Dept Med, Calgary, AB T2N 4N2, Canada
[2] Alberta Bone Marrow Transplant Program, Calgary, AB T2N 4N2, Canada
[3] Foothills Prov Gen Hosp, Dept Med, Calgary, AB T2N 2T9, Canada
[4] Foothills Prov Gen Hosp, Dept Oncol, Calgary, AB T2N 2T9, Canada
[5] Alberta Childrens Prov Gen Hosp, Calgary, AB, Canada
[6] Cross Canc Inst, Edmonton, AB T6G 1Z2, Canada
关键词
acute myelogenous leukemia; blood cell transplant;
D O I
10.1038/sj.bmt.1702051
中图分类号
Q6 [生物物理学];
学科分类号
071011 ;
摘要
We have compared the outcomes of 87 patients with acute myelogenous leukemia (AML) and myelodysplasia (MDS) receiving matched sibling transplants with stem cells from peripheral blood (blood cell transplant, BCT) or bone marrow (BMT), In good risk patients (AML in CR1) granulocytes recovered to 0.5 x 10(9)/l a median of 14 days after BCT compared with 19 days after BMT (P < 0.0001), For patients with poor risk disease (AML beyond CR1 and MDS) corresponding figures were 16 vs 26 days (P < 0.0001). Platelet recovery to 20 x 10(9)/l was also faster after BCT (good risk 12 vs 20 days, P < 0.0001; poor risk 17 vs 22 days, P = 0.04). Red cell transfusions were unaffected by cell source, but BCT recipients required less platelet transfusions (good risk 1 vs 5, P = 0.002; poor risk 5 vs 11, P = 0.004). Blood cell transplants resulted in more chronic GVHD (86% vs 48%, P = 0.005) and a significantly higher proportion of recipients with KPS of 80% or less (48% vs 5%, P = 0.004), Disease-free survival at 4 years was 23% for both groups of poor risk patients but outcome in good risk patients was better after BCT (93% vs 62%, P = 0.047) related mainly to less relapse. While disease-free survival may be better after BCT than BMT for AML in CR1, quality of life may be relatively impaired.
引用
收藏
页码:1177 / 1183
页数:7
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