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Titolo:
Long-term survival and late deaths after allogeneic bone marrow transplantation
Autore:
Socie, G; Stone, JV; Wingard, JR; Weisdorf, D; Henslee-Downey, PJ; Bredeson, C; Cahn, JY; Passweg, JR; Rowlings, PA; Schouten, HC; Kolb, HJ; Klein, JP;
Indirizzi:
Hop St Louis, Serv Hematol Greffe Moelle, Paris, France Hop St Louis Paris France is, Serv Hematol Greffe Moelle, Paris, France Med Coll Wisconsin, Int Bone Marrow Transplant Registry, Hlth Policy Inst,Milwaukee, WI 53226 USA Med Coll Wisconsin Milwaukee WI USA 53226 cy Inst,Milwaukee, WI 53226 USA Univ Florida, Coll Med, Gainesville, FL USA Univ Florida Gainesville FL USA v Florida, Coll Med, Gainesville, FL USA Univ Minnesota, Div Hematol Oncol & Transplantat, Minneapolis, MN USA UnivMinnesota Minneapolis MN USA ol & Transplantat, Minneapolis, MN USA Univ S Carolina, Div Transplantat Med, Columbia, SC 29208 USA Univ S Carolina Columbia SC USA 29208 plantat Med, Columbia, SC 29208 USA Univ Ottawa, Dept Med, Ottawa, ON, Canada Univ Ottawa Ottawa ON CanadaUniv Ottawa, Dept Med, Ottawa, ON, Canada CHU Besancon, Serv Hematol, F-25030 Besancon, France CHU Besancon Besancon France F-25030 v Hematol, F-25030 Besancon, France Kantonsspital Basel, Dept Med, Basel, Switzerland Kantonsspital Basel Basel Switzerland sel, Dept Med, Basel, Switzerland Univ Hosp, Dept Internal Med, Maastricht, Netherlands Univ Hosp Maastricht Netherlands Internal Med, Maastricht, Netherlands Univ Munich, Klinikum Grosshadern, Dept Hematol, D-8000 Munich, Germany Univ Munich Munich Germany D-8000 , Dept Hematol, D-8000 Munich, Germany Univ Munich, Kinderpoliklin, Dept Hematol Oncol, Munich, Germany Univ Munich Munich Germany oliklin, Dept Hematol Oncol, Munich, Germany Med Coll Wisconsin, Dept Pediat, Milwaukee, WI 53226 USA Med Coll Wisconsin Milwaukee WI USA 53226 Pediat, Milwaukee, WI 53226 USA Univ Miami, Sch Med, Div Pediat Hematol Oncol, Miami, FL USA Univ Miami Miami FL USA Sch Med, Div Pediat Hematol Oncol, Miami, FL USA
Titolo Testata:
NEW ENGLAND JOURNAL OF MEDICINE
fascicolo: 1, volume: 341, anno: 1999,
pagine: 14 - 21
SICI:
0028-4793(19990701)341:1<14:LSALDA>2.0.ZU;2-L
Fonte:
ISI
Lingua:
ENG
Soggetto:
ACUTE MYELOGENOUS LEUKEMIA; SEVERE APLASTIC-ANEMIA; CHILDHOOD-CANCER; MYELOID-LEUKEMIA; UNRELATED DONORS; CHEMOTHERAPY; MORTALITY; BLOOD; CURE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
29
Recensione:
Indirizzi per estratti:
Indirizzo: Socie, G Med Coll Wisconsin, Int Bone Marrow Transplant Registry, Hlth Policy Inst,8701 Watertown Plank Rd,POB 26509, Milwaukee, WI 53226 USA Med Coll Wisconsin 8701 Watertown Plank Rd,POB 26509 Milwaukee WI USA 53226
Citazione:
G. Socie et al., "Long-term survival and late deaths after allogeneic bone marrow transplantation", N ENG J MED, 341(1), 1999, pp. 14-21

Abstract

Background and Methods It is uncertain whether mortality rates among patients who have undergone bone marrow transplantation return to the level of the mortality rates of the general population. We analyzed the characteristics of 6691 patients listed in the International Bone Marrow Transplant Registry. All the patients were free of their original disease two years after allogeneic bone marrow transplantation. Mortality rates in this cohort werecompared with those of an age-, sex-, and nationality-matched general population. Cox proportional-hazards regression was used to identify risk factors for death more than two years after transplantation (late death). Results Among patients who were free of disease two yea rs after transplantation, the probability of living for five more years was 89 percent (95 percent confidence interval, 88 to 90 percent). Among patients who underwent transplantation for aplastic anemia, the risk of death by the sixth year after transplantation did not differ significantly from that of a normal population. Mortality remained significantly higher than normal throughout the study among patients who underwent transplantation for acute lymphoblastic leukemia or chronic myelogenous leukemia and through the ninth year among those who underwent transplantation for acute myelogenous leukemia. Recurrent leukemia was the chief cause of death among patients who received a transplant for leukemia, whereas chronic graft-versus-host disease was the chiefcause among those who received a transplant for aplastic anemia. Advanced,long-standing disease before transplantation and active chronic graft-versus-host disease were important risk factors for late death. Conclusions In patients who receive an allogeneic bone marrow transplant as treatment for acute myelogenous or lymphoblastic leukemia, chronic myelogenous leukemia, or aplastic anemia and who are free of their original disease two years later, the disease is probably cured. However, for many years after transplantation, the mortality among these patients is higher than that in a normal population. (N Engl J Med 1999;341:14-21. ) (C)1999, Massachusetts Medical Society.

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Documento generato il 05/04/20 alle ore 12:02:55