Yazarlar : Kebriaei P, Saliba R, Rondon G, Chiattone A, Luthra R, Anderlini P, Andersson B, Shpall E, Popat U, Jones R, Worth L, Ravandi F, Thomas D, O'Brien S, Kantarjian H, de Lima M, Giralt S, Champlin R.

Yayın : Biol Blood Marrow Transplant.

Yayın Yılı : 2011

Pubmed Linki : http://www.ncbi.nlm.nih.gov/pubmed/21867666

Konu : Kemik İliği Nakli

Literatür İçeriği :  

Abstract

PURPOSE:

The introduction of tyrosine kinase inhibitors (TKI) has revolutionized therapy for patients with acute lymphoblastic leukemia (ALL) who have the Philadelphia (Ph) chromosome.

PATIENTS AND METHODS:

A retrospective analysis was conducted on 102 adults and 11 children who received a first matched related (n =60), matched unrelated (n =40), mismatched cord blood (n=12), or haplo-identical (n=1) allogeneic hematopoietic stem cell transplant (HSCT) for Ph+ ALL in first complete remission (n=71), second complete remission (n=11) or with active disease (n=31) between 1990 and 2009. Sixty-seven patients received TKI with upfront ALL therapy, and 32 patients received TKI maintenance following HSCT.

RESULTS:

With median follow-up of 5 years among survivors (range, 1.1-20.4 years), overall survival (OS) was significantly better for patients transplanted in first remission compared with HSCT in advanced disease: 43% vs. 16%, p=0.002. Disease stage and age at time of HSCT, the development of acute GVHD, and decade of HSCT were found to significantly impact OS, progression-free survival (PFS) and non-relapse mortality (NRM) in multivariate analyses.

CONCLUSION:

Allogeneic HSCT provides durable remission for patients with Ph+ ALL in first remission. Neither TKI use pre- nor post HSCT were found to significantly impact transplant outcomes in univariate and multivariate analyses.

Literatür Arşivi