GLORIA

GEOMAR Library Ocean Research Information Access

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
  • 1
    In: British Journal of Haematology, Wiley, Vol. 202, No. 3 ( 2023-08), p. 608-622
    Abstract: Most events that limit life expectancy after allogeneic haematopoietic stem cell transplantation (allo‐HSCT) occur within the first 2 years; however, treatment outcomes in long‐term survivors who survive for at least 2 years post‐HSCT without relapse are yet to be elucidated. To explore the life expectancy trends and late complications and to assess the main mortality‐related factors, we investigated the characteristics of patients who received allo‐HSCT for haematological malignancies from 2007 to 2019 in our centre and survived in remission for 2 years. A cohort of 831 patients was enrolled; of these, 508 received grafts from haploidentical‐related donors (61.1%). The estimated overall survival rate at 10 years was 91.9% (95% confidence interval [CI], 89.8–93.5), which was affected by prior grade III–IV acute graft‐versus‐host disease (GVHD) (hazard ratio [HR] , 2.98; 95% CI, 1.47–6.03; p  = 0.002) and severe chronic GVHD (HR, 3.60; 95% CI, 1.93–6.71; p   〈  0.001). The probability of late relapse and non‐relapse mortality at 10 years was 8.7% (95% CI, 6.9–10.8) and 3.6% (95% CI, 2.5–5.1) respectively. The top cause of late mortality was relapsed (49.0%). Projected long‐term survival in 2‐year disease‐free survivors following allo‐HSCT was excellent. Strategies should be implemented to minimise the late death‐specific hazards in recipients.
    Type of Medium: Online Resource
    ISSN: 0007-1048 , 1365-2141
    URL: Issue
    RVK:
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 1475751-5
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
  • 2
    In: Blood, American Society of Hematology, Vol. 114, No. 22 ( 2009-11-20), p. 1159-1159
    Abstract: Abstract 1159 Poster Board I-181 Background In allogeneic SCT, genetic factors such as donor and recipient gene polymorphisms of pro- and anti-inflammatory cytokines have been associated with the incidence and severity of GVHD. However, the influence of such donor and recipient gene polymorphisms on other outcomes, such as early infection after SCT, has seldom been described. TNFαa, TNF receptorII (TNFRII), IL-10 and TGF gene contain multiple single nucleotide polymorphisms (SNPs) in the promoter and codon region. We thus studied the association of this panel of candidate gene polymorphisms with the incidence of the first episodes of early bacterial infections within 100 days after allo-HSCT. Methods A total of 138 unrelated donor/recipient pairs, who had undergone HLA-matched allo-HSCT from January 2001 to March 2009 at the First Affiliated Hospital of Zhejiang University School of Medicine, were tested for TNFαa(TNFαa-857 C 〉 T, TNFαa-863 C 〉 A, TNFαa-1031 T 〉 C), TNFRII (codon196 T 〉 G), IL-10 (IL10-1082 A 〉 G, IL10-819 T 〉 C, IL10-592 A 〉 C), TGF (TGF-509 T 〉 C, TGF+869 C 〉 T) polymorphism allele frequencies and genotype. SNPs were analysed by Multiplex SnaPshot. We considered the first episodes of early bacterial infections within 100 days after allo-HSCT have developed when sepsis, pneumonia, or septic shock was diagnosed according to previously published criteria. Results (1) 133 patients achieved complete donor chimerism in the peripheral blood and 5 patients had graft failure. All patients achieved an absolute neutrophil count (ANC) greater than 0.5×109/L at day 13 (7∼22) and platelet recovery at day 15 (7∼64). The cumulative incidence of at least one bacterial infection was 47.8% (pneumonia and intestinal infection are the most popular) within 100 days after allo-HSCT. There is no significant difference in the time to neutrophil recovery in patients who experienced early bacterial infections with those who did not (13.6 vs 12.8,P=0.115). (2) The TNFαa-857 C/C genotype and TNFRII 196 T/T genotype of the donor were significantly associated with a higher risk of early bacterial infection ( for TNFαa-857 C/C genotype: 53.3% vs 29.0%, P=0.024 ; TNFRII 196 T/T genotype: 53.5% vs 33.3%, P=0.038); (3) The TGF-509 T/T genotype of the donor was significantly associated with a higher risk of early bacterial infection (62.5% vs 41.8, P=0.038); (4) Transplantation from donors with IL10-819 C/C genotype or IL10-592 C/C genotype were significantly associated with a higher risk of early bacterial infection (for IL10-819 C/C genotype: 71.4.1% vs 45.3%, P=0.034; IL10-592 C/C genotype: 70.0.1% vs 45.8%, P=0.055); (5) The genotypes of TNFαa-863, TNFαa-1031, IL10-1082 and TGF+869 were not found to be associated with the risk of early bacterial infection. Conclusions Recent studies have shown that the generation potential of IL-10 is influenced by the polymorphism of the IL-10 gene. The IL10-819*C allele and IL10-592 *C allele are associated with higher secretion of IL-10 than IL10-819*T allele and IL10-592*A allele. In our data, a higher risk of early bacterial infection with IL10-819 C/C and IL10-592 C/C genotype was postulated to be associated with a higher IL-10 production, which suppressed reactive T-cell response. These results, which is the first report of TNFαa, TNFRII, IL-10and TGF polymorphic features of Chinese population with the risk of early bacterial infection after HLA-matched unrelated allo-HSCT, suggest an interaction of the donor TNFαa-857C/C, TNFRII 196 T/T, IL10-819 C/C, IL10-592 C/C and TGF-509 T/T genotypes on risk of early infection. These results are helpful for predict allo-HSCT outcome, identify more suitable donors and clarify therapy on an individual patient basis. Disclosures No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2009
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
  • 3
    In: American Journal of Hematology, Wiley
    Type of Medium: Online Resource
    ISSN: 0361-8609 , 1096-8652
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 1492749-4
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
  • 4
    In: Blood, American Society of Hematology, Vol. 116, No. 21 ( 2010-11-19), p. 4829-4829
    Abstract: Abstract 4829 Bortezomib is effective in multiple myeloma, but also in other malignancies, particularly in lymphoma. Here we present a-23-year-old-male patient who complained of a progressive chest pain for 2 years. The CT scan of local hospital showed a mass that measured 5×14cm in the anterior mediastinum. He also had multiple lymphadenopathies in other areas. Tissue biopsy verified Classical Hodgkin lymphoma, nodular sclerosis (NDHL) IIIA. Then he had 12 cycles of ABVD, 1 cycle of MINE and CHOPE, 2 cycles of Hyper-CVAD regimen as prior treatments. Initial therapies induced good responses, but his disease progressed before he was transferred to hospital on December 29, 2009. His blood counts showed that WBC 30×10E9/L, with 89% neutrophils, Hb 99g/L, platelet 452 ×10E9/L. Bone marrow aspiration with immunophenotyping, analysis of TCR/IgH and the chromosome were normal. Biopsy reconfirmed the diagnosis of Hodgkin lymphoma. Lymphoma masses in his right neck, and severe edema with his right arm. He was treated with 2 cycle of IGVP regimen (ifosfamide, gemzar, vindesine, prednsone) and 2 cycles of GIP regimen (ifosfamide, gemzar, prednsone). With more progression, he subsequently received methotrexate and Ara-c with minimal response. Two weeks later, CT showed lung infection and pleural effusion, multiple lymphadenopathy. Lymph nodes decreased mildly and edema disappeared temporary after 3 cycles of R-CHOP. He was then treated with Bortezomib, dexamethasone and L-ADM. Four days after the first cycle, lymphoma masses decreased and significantly and his edema resolved. Due to the severe periphery neuropathy, he declined bortezomib, so 2 weeks later, the symptoms back again, and the FMD regimen (fludarabine, mitoxantrone, dexamethasone) was given. He then chose palliative radiation treatment and eventually died of pneumonia. Nearly 30%-40% of Hodgkin lymphoma relapsed after first line therapy even responds well at the initial stage. To these relapsed ones, the second line therapy including salvage chemotherapy and ASCT (autologous stem cell transplantation) act as the major treatment, but only a minority patients benefit from it. Treatment is limited to relapse and refractory ones hence they deserved more focus. The Bortezomib + L-ADM regimen exhibiting its efficacious after two cycles and the condition changed obviously. Our case is showing more antitumor activity of the new combination relative to either single agent alone. The new regimen responded well and with milder bone marrow suppression. Further study is still needed to demonstrate the relationship between the effective duration and treatment cycles. Some results showed that bortezomib inhibited cell proliferation and induced apoptosis in HL cell lines in a dose-dependent manner. At the same time, it is imperative to be aware of the adverse effects, such as peripheral neuropathy, thrombocytopenia and herpes zoster. As the patient mentioned above, the new regimen may work more optimally if more cycles were carried out, and he would have eventually responded if the complication was well controlled. Disclosures: No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2010
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
  • 5
    In: Blood, American Society of Hematology, Vol. 116, No. 21 ( 2010-11-19), p. 4524-4524
    Abstract: Abstract 4524 Graft failure or graft rejection is a serious and potentially life-threatening complication after allogeneic hematopoietic stem cell transplantation (HSCT), which occurs at an overall frequency of less than 5%. Before 2005, in our unit we tried to manage this complication by infusion of hematopoietic stem cells (HSCs) from an alternative donor (n=2) or cord blood (n=2). Unfortunately, these 4 patients could not achieve neutrophil engraftment and died of serious infections. Thus, in case of engrafment failure, donor reneging or other unpredictable conditions, we have advised the storage of “back-up” cells for all patients undergoing unrelated allo-HSCT since 2005. Before allo-HSCT, patients with chronic myelogenous leukemia (CML) mobilized with G-CSF after intravenous cyclophosphamide 2g/m2 for 2 days, whereas patients with other acute leukemia mobilized with G-CSF during the agranulocytosis phase after chemotherapy. “Back-up” cells were harvested as soon as white blood cell count was greater than 2×109/L, and cryopreserved in liquid nitrogen. From Jan 2005 to Dec 2009, 118 patients stored autologous “backup” cells, among whom 19 CML patients underwent fludarabine based reduced intensity conditioning regimen, and other patients underwent BuCy based myeloablative conditioning regimen. All patients underwent non-manipulated marrow or peripheral stem cell transplantation. None of these 118 patients developed harvest- related- complication when “back-up” cell mobilization and harvest. The medial mononuclear cells (MNC) count in “back-up” cells was 5×108/kg (2.71-11.3×108/kg). Engraftment was defined as absolute neutrophil count 〉 0.5×109/L for 3 successive days and platelet count 〉 20×109/L independent of transfusions. Engraftment was monitored by following complete blood counts, chimerism studies and BM biopsies. In total, 4 patients (2 of 19 patients who underwent reduced intensity conditioning regimen and 2 of 99 patients who underwent myeloablative conditioning regimen) re-infused “back-up” cells at once when the engraft failure was diagnosed. The media interval between allo-HSCT and re-infusion of “Back-up” cells were 39.5 day (range from 24 days to 50 days). The median MNC counts of re-infused cells were 4.49×108/Kg (range from 4.10 to 5.15). 3 of the 4 patients achieved successful hematological reconstitution within 13 days, and the fourth patient was still pancytopenia during 23 days after the re-infusion of “back-up” cells with BM examination revealing severe BM hypoplasia. However, second HSCT from a haploidentical donor following a fludarabine (Flu)- and anti-thymocyte globulin (ATG)-based conditioning regimen resulted in hematological reconstitution. After re-infusion of “Back-up” cells, 2 patients with CML and 1 patient with Ph+ ALL received continuing imatinib treatment and the fourth patient who underwent second haploidentical donor HSCT was watchful waited. One patient who diagnosed with CML was still alive for 4.5 years after the re-infusion of “back-up” cells, and recurrent detection of the expression of BCR/ABL fusion gene showed complete cytogenetic remission. Another CML patient died of progression of disease and intracranial hemorrhages in 7 months after the re-infusion of “back-up” cells The patient who diagnosed with ALL (Ph+) was still alive for 2.3 years after the re-infusion of “back-up” cells, and recurrent bone marrow aspiration examinations showed complete remission. The patient diagnosed with AML and underwent second haploidentical transplantation was alive in CR for 1.8 years. Our experience suggests that re-infusion of cryopreserved “back-up” cells could provide a safe and effective therapeutic strategy for engraftment failure after unrelated allo-HSCT in adult patients. Disclosures: No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2010
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
  • 6
    In: Blood, American Society of Hematology, Vol. 116, No. 21 ( 2010-11-19), p. 4511-4511
    Abstract: Abstract 4511 Background: Hematologic relapse after Allogeneic Hematopoietic Stem Cell Transplantation (HSCT) is associated with a dismal prognosis. Increasing minimal residual disease (MRD) after HSCT had been proved highly effective prognostic factor for post-treatment leukemia relapse. Savage chemotherapy or intensive conditioning followed by a second HSCT may be applied, but associated with a high mortality and a low rate of complete remission. Donor lymphocyte infusion (DLI) has been shown to exert a graft-versus-leukemia (GVL) effect and has been successfully used in patients who relapsed after HSCT. Objective: In this retrospective study, we sought to gain insights of the effect of DLI on clinical outcomes such as graft versus host disease (GVHD), overall survival (OS), disease free survival (DFS), and treatment-related mortality (TRM) in patients with either relapsed hematological malignancies or increasing MRD who underwent HSCT. Methods: DLIs were administered to 25 patients [10(40%) acute myeloid leukemia, 10 (40%) acute lymphoblastic leukemia, 5 (20%) chronic myeloid leukemia]. Patients with Acute leukemia had been treated with myeloablative conditioning (BuCy). Patients with chronic myeloid leukemia had been treated with non-myeloablative conditioning(Flu,ATG and Bu). Infusion of al logeneic hematopoietic stem cells are performed at our institution from 2005 to 2010. GVHD prophylaxis consisted of CsA, MMF and MTX.10 patients were diagnosed of hematologic relapse a median of 259 (30–850) days after HSCT. 15 patients had persistent increasing MRD(monitoring with flow cytometry or RT-PCR for Fusion Gene) after HSCT. DLIs were given to patients who had relapsed hematological malignancies or persistent increasing MRD. Patients with relapsed malignancies were performed reinduction chemotherapy simultaneously. A total of 57 DLIs were administered to 25 patients a median of 809 (92-1981) days after HSCT. The median transplant dose of CD3(+) cells is 4.12*10e7/kg (2.68*10e7/kg–7.97*10e7/kg). Results: The overall response rate of DLI was 80% for CML, 90% for ALL and 80% for AML.The response rate was 93.3% in patients with increasing MRD, whereas 60% in patients with relapsed malignancies. A total of 10 patients (40%,7 with increasing MRD, 3 with relapsed malignancies) developed acute GVHD. A complete response was achieved in 72% of the patients. TRM was 12% (3 patients with increasing MRD). The Kaplan-Meier estimate of OS and DFS at 3 years after DLI were 62.5% and 60.9%, respectively, with a median follow-up of 411 (32-1509) days for survivors. In patients with increasing MRD, the 3-year OS and DFS after DLI were 78.6% and 77.8%, respectively, with a median follow-up of 531(40-1509) days. In patients with relapsed malignancies,the 3-year OS and DFS after DLI were 40% and 36.8%, respectively, with a median follow-up of 469 (32-1393) days. Conclusion: Leukemia relapse is a serious therapeutic challenge following HSCT. In this retrospective study, DLIs was proved to be an effectively therapy to prevent relapse and get a better Clinical outcome in leukemia patients. Patients undergone DLI without leukemia relapse had a better outcome than the relapse group. Further strategies are required to detect early relapse in HSCT patients, and DLI may be a strategy to prevent relapse in high risk patients. Disclosures: No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2010
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
  • 7
    In: Blood, American Society of Hematology, Vol. 116, No. 21 ( 2010-11-19), p. 5036-5036
    Abstract: Abstract 5036 Multiple myeloma (MM) is a malignant neoplasm of plasma. With conventional chemotherapy, the rates of complete remission (CR) or very good partial remission (VGPR) are still low. Little has been reported on Bortezomib-based therapies specifically in the Chinese pateitns with MM. Here we report our results with combination therapy based on bortezomib in the Chinese population. We investigated the efficacy and safety of Bortezomib-based therapies in previously untreated MM patients. Methods: Between June 2006 and June 2010, 61 consecutive newly-diagnosed patients with symptomatic MM were treated with combination therapies based on Bortezomib. Forty-two patients were male and 19 were female. Median age was 59 years (range 37–86 years). Forty-four patients were stage 3 according to the International Staging System, 6 patients were stage 2 and 11 patients were stage 1. The conbinations included dexamethasone, dexamethasone plus subsequent thalidomide and dexamethasone plus cyclophosphamide. In detail, Bortezomib was at the dose of 1.3 mg per square meter IV on days 1, 4, 8, 11 and dexamethasone at 20 mg per square meter IV daily on the day of bortezomib and the day after, with or without daily oral thalidomide that was escalated from 100 mg to 200 mg (BD group or BDT group) or plus cyclophosphamide at 0.2 per square meter IV on days 1 to days 4 (BDC group). Thirty-four patients were in BDT group, 12 in BD group and 15 in BDC group. All patients received a median of three cycles of therapy (range 1–6). The IMWG criteria were used for response evaluation and toxicities were evluated according to the NCI Common Toxicity Criteria version 3. Results: The proportions of patients with very good partial response (VGPR) or better were 38% (13/34), 25% (3/12) and 60% (9/15) in BDT, BD and BDC group, respectively; 44% (15/34), 33% (4/12) and 33% (5/15) achieved partial response (PR). Therefore the overall response (VGPR plus PR) were 82% (28/34), 58% (7/12) and 93% (14/15). Three patients died with severe infection without disease progression. Grade 3–4 toxicities included fatigue (4/34, 1/12 and 4/15), thrombocytopenia (8/34, 3/12 and 5/15), diarrhea (4/34, 2/12 and 2/15) and infection (7/34,3/12,6/15) in BDT, BD and BDC group, respectively. Grade 1–2 neuropathy were occurred in 20 patients (59%), 6 patients (50%) and 9 patients (60%) and grade 3–4 were occurred in 6 (18%), 1 (8%) and 1 (7%) in BDT, BD and BDC group, respectively. Herpes zoster occurred in 6 patients (18%), 1 patients (8%) and 2 patients (13%) respectively. Routine anticoagulation or anti-thrombsis were not used. Only 1 patient suffered from DVT/PE but did well with treatment. Conclusions: Our preliminary experience in Chinese patients indicated that combination chemotherapy based on Bortezomib is highly effective in newly-diagnosed multiple myeloma and BDC or BDT regimens may be more superior than BD in Chinese population. There were relative lower rates of grade 3–4 neuropathy and DVT/PE in the Chinese patients with MM receved combination chemotherapy based on bortezomib. Disclosures: No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2010
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
  • 8
    In: Blood, American Society of Hematology, Vol. 118, No. 21 ( 2011-11-18), p. 5075-5075
    Abstract: Abstract 5075 Multiple myeloma (MM) is a malignant disorder characterized by abnormal proliferation of monoclonal, immunoglobulin producing plasma cells in the bone marrow. Studies with large samples have shown that molecular cytogenetic changes play an important role in the prognosis of MM. Based upon these findings, we tested cytogenetic aberrations of 65 patients with MM by conventional cytogenetics analysis and FISH technique in this study. Retrospective study was done on these cases for clinical features. Methods: This is a retrospective analysis of 65 patients with MM diagnosed between June 2007 and May 2010 including 13 relapsed cases and 52 newly diagnosed patients. Patients received bortezomib-based combination chemotherapy including bortezomib plus dexamethasone (BD) and the triplet combinations (bortezomib, adriamycin, dexamethasone (BAD), bortezomib, cytoxan, dexamethasone (BCD) and bortezomib, melphalan, prednisone (BMP) or traditional chemotherapy including doxorubicin, vincristine plus dexamethasone (VAD), melphalan plus dexamethasone (MP), melphalan, dexamethasone plus thalidomide (MPT)). To further clarify the correlation between cytogenetic and clinical features on patients with multiple myeloma, we used conventional cytogenetics analysis with R-banding technique and interphase fluorescence in situ hybridization (FISH) to describe the molecular cytogenetic characterization of bone marrow nucleated cells from 65 patients. SPSS (version 18.0) software was used for data analysis, χ2 tests or Fisher's exact test was used for betweengroup comparison of the discrete variables and Log- Rank was used for survival analysis. p 〈 0.05 reflects the remarkable significance. Results: 16.9% of patients (11/65) showed abnormal cytogenetic aberrations including 90.9% (10/11) cases with ultra complex aberration and complex aberration via conventional cytogenetics. In addition, we were able to show aberrations in 49.2% (32/65) of patients by interphase FISH analysis. Abnormalities of 13q14, 1q21, 14q32 and 17p13 were detected in 27.7% (18/65), 13.8% (9/65), 16.9% (11/65), and 29.2% (19/65) by FISH, respectively. 1q21 amplification is strongly associated with 13q14 mutation (P=0.008), demonstrating significant correlation between two. Abnormality of 13q14 deletion or 1q21 amplification were associated with lower levels of albumin (P 〈 0.05). Patients with 13q14 deletion frequently had stage III disease by DS and ISS staging, and compared with patients not detected on FISH analysis, they tended to have elevated serum levels of β2-microglobulin at diagnosis (P 〈 0.05). 17p13 deletion coexistent with 13q14 deletion frequently correlate with elevated serum levels of β2-microglobulin and advanced clinical staging. The median progression-free survival (PFS) of patients with 17p13 deletion or 17p13/13q14 aberrations were both 11.0m, significantly lower than patients with no detected abnormality (median PFS 19.0m) (P 〈 0.05). The median overall survival (OS) of patients with FISH negtive results was 38.0m, significantly higher than those with 13q14, 14q32 or 1q21 abnormality and 17p13/13q14 or more than three abnormalities (P 〈 0.05). Conclusions: This study validates myeloma cells are prone to show complex aberration and FISH is superior in the detection of cytogenetic aberrations to conventional cytogenetics analysis for patients with multiple myeloma. 1q21 had significant correlation to 13q abnormality. 17p13 deletion coexist with 13q14 deletion and 14q32 rearrangeent were used to associate with poor prognosis. 17p13 deletion or 17p13/13q14 deletion was associated with poorer PFS while abnormality of 13q14, 1q21,14q32, 17p13/13q14 or more than 3 abnormalities were correlate with poorer OS. Disclosures: No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2011
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
  • 9
    In: Blood, American Society of Hematology, Vol. 112, No. 11 ( 2008-11-16), p. 4417-4417
    Abstract: Allogeneic hematopoietic stem cell transplantation (alloSCT) is nowadays most frequently applied in patients with acute myeloid leukemia (AML), and it effectively reduces the relapse as its stronger graft-versus-leukemia (GVL) effect, however, the appropriate role and timing of alloSCT in AML are poorly defined. We retrospectively investigated the outcomes of unrelated donor hematopoietic stem cell transplantation (URD-HSCT, n=51; 44 in CR1, 7 beyond CR1) and sibling donor BMT (Sib-HSCT, n=31; 24 in CR1, 7 beyond CR1) for AML between April 1999 and April 2008. The median age of all patients was 27.5 years (range 12–49 years), and HLA high-resolution typing was used for donor-recipient matching with 35 cases of HLA-matched and 16 cases of HLA 1–2 alleles mismatched in URD-HSCT group, while 28 cases of HLA-matched and 3 cases of HLA 1–2 alleles mismatched in Sib-HSCT group. All of the patients were received Bu/Cy or Bu/Cy modified myeloablative conditionging regimen. Mycophenolate mofetil (MMF) combined with CsA and short course MTX were performed to prevent aGVHD and 4 patients in unrelated donor transplant group received additional anti-CD25 monoclonal antibody to prevent severe aGVHD. Hemopoietic recovery and was observed in all patients and the median time to achieve ANC & gt;0.5×109/L was 12.5 days (range 7–22 days), platelets & gt;20×109/L was 15 days (range 9–144 days), and engraftment of neutrophil and platelet did not differ between the two transplant groups. The incidence of aGVHD was significantly higher in URD-HSCT group (54.9% vs 19.4%, p & lt;0.001), however, there was no different of severe aGVHD (13.7% vs 3.2%, p & gt;0.05) and transplant-related mortality (11.8% vs 3.2%, p & gt;0.05) at 100 days between URD-HSCT and Sib-HSCT groups. With a median follow-up of 16.2 months, the 3 years overall survival of the total patients was 73.90±5.11%, and there were no different of disease free survival between AML patients in CR1 and beyond CR1 (69.12% vs 64.29%, p & gt;0.05). Relapse occurred in 15.7% and 9.7% patients following unrelated and sibling donors transplantation respectively, and 3 years disease free survival were 63.85±6.85% and 79.55±7.48% respectively (p & gt;0.05). Based on the data, alloSCT provides a better prospect for cure and would be mostly recommended for patients with AML either in CR1 or beyond CR1, which could be able to improve the leukemia free survival. The outcome of unrelated donor transplantation is comparable to that of sibling donor transplantation for AML. Unrelated donor should be considered in AML patients without a proper sibling donor, especially to patients with unfavorable cytogenetics. MMF combined with CsA and MTX could prevent severe aGVHD efficiently which would reduce the transplant-related mortality in URD-HSCT. At the same time, modifications of supportive care and preparative regimens continue to improve results and extend the application of alloSCT in AML.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2008
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
  • 10
    In: PLoS ONE, Public Library of Science (PLoS), Vol. 9, No. 6 ( 2014-6-11), p. e99174-
    Type of Medium: Online Resource
    ISSN: 1932-6203
    Language: English
    Publisher: Public Library of Science (PLoS)
    Publication Date: 2014
    detail.hit.zdb_id: 2267670-3
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...