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Titolo:
Thiotepa, busulfan and cyclophosphamide as a preparative regimen for allogeneic transplantation for advanced chronic myelogenous leukemia
Autore:
Przepiorka, D; Khouri, I; Thall, P; Mehra, R; Lee, MS; Ippoliti, C; Giralt, S; Gajewski, J; van Besien, K; Andersson, B; Korbling, M; Deisseroth, AB; Champlin, R;
Indirizzi:
Univ,Texas, MD Anderson Canc Ctr, Dept Blood & Marrow Transplantat, Houston Univ Texas Houston TX USA 77030 Dept Blood & Marrow Transplantat, Houston Univ Texas, MD Anderson Canc Ctr, Dept Biomath, Houston, TX 77030 USA UnivTexas Houston TX USA 77030 Ctr, Dept Biomath, Houston, TX 77030 USA Univ Texas, MD Anderson Canc Ctr, Dept Lab Med, Houston, TX 77030 USA UnivTexas Houston TX USA 77030 Ctr, Dept Lab Med, Houston, TX 77030 USA
Titolo Testata:
BONE MARROW TRANSPLANTATION
fascicolo: 10, volume: 23, anno: 1999,
pagine: 977 - 981
SICI:
0268-3369(199905)23:10<977:TBACAA>2.0.ZU;2-#
Fonte:
ISI
Lingua:
ENG
Soggetto:
BONE-MARROW TRANSPLANTATION; TOTAL-BODY IRRADIATION; MINIMAL RESIDUAL DISEASE; CHRONIC MYELOID-LEUKEMIA; VENOOCCLUSIVE DISEASE; PHASE-I; LIVER; TOXICITY; THERAPY;
Keywords:
allogeneic bone marrow transplantation; chronic myelogenous leukemia; thiotepa; busulfan;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
27
Recensione:
Indirizzi per estratti:
Indirizzo: Przepiorka, D Baylor,Coll Med, Ctr Cell & Gene Therapy, 1102 Bates St,Suite 1100, Houston Baylor Coll Med 1102 Bates St,Suite 1100 Houston TX USA 77030
Citazione:
D. Przepiorka et al., "Thiotepa, busulfan and cyclophosphamide as a preparative regimen for allogeneic transplantation for advanced chronic myelogenous leukemia", BONE MAR TR, 23(10), 1999, pp. 977-981

Abstract

Thirty-six adults with chronic myelogenous leukemia (CML) in second or greater chronic phase, accelerated phase, or blast crisis underwent marrow or blood stem cell transplantation from an HLA-matched sibling using high-dosethiotepa, busulfan and cyclophosphamide (TBC) as the preparative regimen. All evaluable patients engrafted and had complete donor chimerism. One patient failed to clear meningeal leukemia, and one patient had one of 30 metaphases positive for the Philadelphia chromosome at 2 months post transplant. The remainder of the patients studied had eradication of CML documented bycytogenetics and/or Southern blot for BCR gene rearrangement, and 13 of 15patients studied became negative for the BCR gene rearrangement by polymerase chain reaction. Three-year relapse rate is 42% (95% CI, 19-64%), The relapse rate was significantly lower for patients transplanted without blast crisis (9% vs 100%, P < 0.001). Eight (22%, 95% CI, 10-39%) patients had severe or fatal veno-occlusive disease (VOD), Elevated liver enzymes within 1month prior to transplantation and transplantation using marrow were significantly associated with the occurrence of VOD. Three-year survival is 28% (95% CI, 13-43%). Survival was significantly higher for patients transplanted without blast crisis (45 % vs 0 %, P = 0.01). TBC is an effective preparative regimen for CML in accelerated phase but not refractory blast crisis,and it should be used with caution in patients with prior hepatopathy who have an increased risk of severe VOD.

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Documento generato il 04/07/20 alle ore 13:00:49