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Titolo:
HIGH-DOSE ETOPOSIDE, CYCLOPHOSPHAMIDE AND TOTAL-BODY IRRADIATION WITHALLOGENEIC BONE-MARROW TRANSPLANTATION FOR RESISTANT ACUTE MYELOID-LEUKEMIA - A STUDY BY THE NORTH-AMERICAN MARROW TRANSPLANT GROUP
Autore:
BROWN RA; WOLFF SN; FAY JW; PINEIRO L; COLLINS RH; LYNCH JP; STEVENS D; GREER J; HERZIG RH; HERZIG GP;
Indirizzi:
WASHINGTON UNIV,SCH MED,DEPT MED,DIV BONE MARROW TRANSPLANTAT & STEM CELL BIOL,660 S EUCLID ST LOUIS MO 63110
Titolo Testata:
Leukemia & lymphoma
fascicolo: 3-4, volume: 22, anno: 1996,
pagine: 271 - 277
SICI:
1042-8194(1996)22:3-4<271:HECATI>2.0.ZU;2-J
Fonte:
ISI
Lingua:
ENG
Soggetto:
ACUTE MYELOGENOUS LEUKEMIA; UNTREATED 1ST RELAPSE; HEMATOLOGICAL MALIGNANCIES; PREPARATIVE REGIMEN; HOST DISEASE; PHASE-I; BUSULFAN; REMISSION; GRAFT; CYTARABINE;
Keywords:
HIGH DOSE ETOPOSIDE; CYCLOPHOSPHAMIDE; TBI; ALLOGENEIC BONE MARROW TRANSPLANTATION; RESISTANT LEUKEMIA; AML;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
32
Recensione:
Indirizzi per estratti:
Citazione:
R.A. Brown et al., "HIGH-DOSE ETOPOSIDE, CYCLOPHOSPHAMIDE AND TOTAL-BODY IRRADIATION WITHALLOGENEIC BONE-MARROW TRANSPLANTATION FOR RESISTANT ACUTE MYELOID-LEUKEMIA - A STUDY BY THE NORTH-AMERICAN MARROW TRANSPLANT GROUP", Leukemia & lymphoma, 22(3-4), 1996, pp. 271-277

Abstract

We evaluated the toxicity and efficacy of high-dose etoposide, cyclophosphamide and total body irradiation (TBI) followed by allogeneic bone marrow transplantation (BMT) for patients with resistant, acute myeloid leukemia (AML). Between 9/84 and 11/92 we treated 70 patients withetoposide (900-1800 mg/m2), cyclophosphamide (120-180 mg/kg) and TBI (1000-1200 cGy) followed by allogeneic BMT from histocompatible siblings. Forty patients were in untreated first relapse. Median time from diagnosis to transplant was 10 months. Toxicity was similar to that observed with cyclophosphamide/TBI with the median duration of neutropenia (ANC < 500/mu l) being 19 days (range 10-27) and the median durationof thrombocytopenia being 23 days (range 13-173). Twenty-three patients remain in continuous complete remission at a median of 56 months after transplant (range 36-132 months). Probabilities of disease-free survival, persistent/recurrent disease and transplant related mortality are .32, .47, and .37 respectively. Multivariate analysis indicated that grade greater than or equal to 2 acute graft-vs-host disease and transplant in untreated first relapse were associated with increased DFSdue to reduced relapse risk. We conclude that high-dose etoposide with cyclophosphamide and TBI followed by allogeneic BMT is effective therapy for resistant AML, producing durable remission in approximately one-third of those treated. Disease persistence or recurrence was the major cause of treatment failure. Further improvement in DFS following allogeneic BMT for resistant AML might be achieved by using less intensive GVHD prophylaxis or through infusion of donor peripheral blood cells in patients who fail to develop significant acute GVHD.

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Documento generato il 15/07/20 alle ore 18:59:39