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Titolo:
Treatment of relapsed leukemia after unrelated donor marrow transplantation with unrelated donor leukocyte infusions
Autore:
Porter, DL; Collins, RH; Hardy, C; Kernan, NA; Drobyski, WR; Giralt, S; Flowers, MED; Casper, J; Leahey, A; Parker, P; Mick, R; Bate-Boyle, B; King, R; Antin, JH;
Indirizzi:
Univ Penn, Med Ctr, Div Hematol Oncol, Dept Med, Philadelphia, PA 19104 USA Univ Penn Philadelphia PA USA 19104 Dept Med, Philadelphia, PA 19104 USA Univ Penn, Med Ctr, Dept Epidemiol & Biostat, Dept Med, Philadelphia, PA 19104 USA Univ Penn Philadelphia PA USA 19104 Dept Med, Philadelphia, PA 19104 USA Univ Texas, SW Med Ctr, Div Hematol Oncol, Dallas, TX USA Univ Texas Dallas TX USA , SW Med Ctr, Div Hematol Oncol, Dallas, TX USA Baylor Sammons Canc Ctr, Dallas, TX USA Baylor Sammons Canc Ctr Dallas TXUSA r Sammons Canc Ctr, Dallas, TX USA Mem Sloan Kettering Canc Ctr, New York, NY 10021 USA Mem Sloan Kettering Canc Ctr New York NY USA 10021 New York, NY 10021 USA Med Coll Wisconsin, Dept Med, Div Hematol Oncol, Milwaukee, WI 53226 USA Med Coll Wisconsin Milwaukee WI USA 53226 Oncol, Milwaukee, WI 53226 USA Med Coll Wisconsin, Div Pediat, Bone Marrow Transplant Program, Milwaukee,WI 53226 USA Med Coll Wisconsin Milwaukee WI USA 53226 Program, Milwaukee,WI 53226 USA Univ Texas, MD Anderson Canc Ctr, Dept Hematol, Houston, TX 77030 USA UnivTexas Houston TX USA 77030 Ctr, Dept Hematol, Houston, TX 77030 USA Univ Washington, Fred Hutchinson Canc Res Ctr, Seattle, WA 98195 USA Univ Washington Seattle WA USA 98195 Canc Res Ctr, Seattle, WA 98195 USA Childrens Hosp Philadelphia, Div Oncol, Philadelphia, PA 19104 USA Childrens Hosp Philadelphia Philadelphia PA USA 19104 lphia, PA 19104 USA City Hope Natl Med Ctr, Duarte, CA 91010 USA City Hope Natl Med Ctr Duarte CA USA 91010 Med Ctr, Duarte, CA 91010 USA Natl Marrow Donor Program, Minneapolis, MN USA Natl Marrow Donor Program Minneapolis MN USA rogram, Minneapolis, MN USA Dana Farber Partners Canc Care, Dept Adult Oncol, Boston, MA USA Dana Farber Partners Canc Care Boston MA USA Adult Oncol, Boston, MA USA Brigham & Womens Hosp, Dept Med, Boston, MA 02115 USA Brigham & Womens Hosp Boston MA USA 02115 Dept Med, Boston, MA 02115 USA Harvard Univ, Sch Med, Boston, MA USA Harvard Univ Boston MA USAHarvard Univ, Sch Med, Boston, MA USA
Titolo Testata:
BLOOD
fascicolo: 4, volume: 95, anno: 2000,
pagine: 1214 - 1221
SICI:
0006-4971(20000215)95:4<1214:TORLAU>2.0.ZU;2-V
Fonte:
ISI
Lingua:
ENG
Soggetto:
CHRONIC MYELOGENOUS LEUKEMIA; CHRONIC MYELOID-LEUKEMIA; POLYMERASE CHAIN-REACTION; VERSUS-HOST DISEASE; ADOPTIVE IMMUNOTHERAPY; TRANSFUSIONS; EFFICACY; LYMPHOCYTES; TOXICITY; CELLS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
34
Recensione:
Indirizzi per estratti:
Indirizzo: Porter, DL Univ Penn, Med Ctr, Div Hematol Oncol, Dept Med, 16 Penn Tower,3400 SpruceSt, Philadelphia, PA 19104 USA Univ Penn 16 Penn Tower,3400 Spruce St Philadelphia PA USA 19104
Citazione:
D.L. Porter et al., "Treatment of relapsed leukemia after unrelated donor marrow transplantation with unrelated donor leukocyte infusions", BLOOD, 95(4), 2000, pp. 1214-1221

Abstract

The efficacy and toxicity of donor leukocyte infusions (DLI) after unrelated donor bone marrow transplantation (BMT) is largely unknown. We identified 58 recipients of unrelated DLI (UDLI) for the treatment of relapsed disease from the National Marrow Donor Program database. A retrospective analysis was performed to determine response, toxicity, and survival after UDLI and to identify factors associated with successful therapy. UDLI was administered for relapsed chronic myelogenous leukemia (CML) (n = 25), acute myelogenous leukemia (AML) (n = 23), acute lymphoblastic leukemia (ALL) (n = I), and other diseases (n = 3). Eight patients were in complete remission (CR) before UDLI, and 50 were evaluable for response. Forty-two percent (95% confidence interval [CI], 28%-56%) achieved CR, including 11 of 24 (46%; 95% CI, 26%-66%) with CML, 8 of 19(42%; 95% CI, 20%-64%) with AML, and 2 of 4 (50%; 95% CI, 1%-99%) with ALL. The estimated probability of disease-free survival (DFS) at 1 year after CR was 65% (95% CI, 50%-79%) for CML, 23% (95% CI, 9%-38%) for AML, and 30% (95% CI, 6%-54%) for ALL. Acute graft-versus-host disease (GVHD) complicated UDLI in 37% of patients (grade II-IV, 25%). A total of 13 of 32 evaluable patients (41%) developed chronic GVHD. There was no association between cell dose administered and either response or toxicity. In a multivariable analysis, only a longer interval from BMT to relapse and BMT to UDLI was associated with improved survival and DFS, respectively. UDLI is an acceptable alternative to other treatment options for relapse after unrelated donor BMT. (Blood. 2000;95:1214-1221) (C) 2000 by The American Society of Hematology.

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Documento generato il 23/09/20 alle ore 13:14:14