Trends in use of and survival after autologous hematopoietic cell transplantation in North America, 1995-2005: significant improvement in survival for lymphoma and myeloma during a period of increasing recipient age.

Trends in use of and survival after autologous hematopoietic cell transplantation in North America, 1995-2005: significant improvement in survival for lymphoma and myeloma during a period of increasing recipient age.
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DOI:
10.1016/j.bbmt.2013.04.027
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发表时间:
2013-07
影响因子:
4.3
通讯作者:
Majhail, Navneet S.
Majhail, Navneet S.
中科院分区:
医学2区
文献类型:
--
作者:
McCarthy, Philip L., Jr.;Hahn, Theresa;Hassebroek, Anna;Bredeson, Christopher;Gajewski, James;Hale, Gregory;Isola, Luis;Lazarus, Hillard M.;Lee, Stephanie J.;LeMaistre, Charles F.;Loberiza, Fausto;Maziarz, Richard T.;Rizzo, J. Douglas;Joffe, Steven;Parsons, Susan;Majhail, Navneet S.

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自体造血细胞移植(autoHCT)用于复发性和复发性恶性疾病,并作为选定恶性肿瘤初始治疗的一部分。本研究描述了一个基于人群的队列的使用、技术和生存率的变化,该队列包括1994-2005年在美国或加拿大中心接受首次autoHCT的68,404例患者,并报告给国际血液和骨髓移植研究中心(CIBMTR)。1996-1999年期间进行了最高的年度平均autoHCT(平均每年6,948次),随后下降(平均每年4,783次),主要是由于乳腺癌autoHCT减少。然而,autoHCT的年平均值从1994-1995年的每年5,278例增加到2004-2005年的每年5,459例,反映了多发性骨髓瘤(MM)、非霍奇金淋巴瘤(NHL)和霍奇金淋巴瘤(HL)的使用增加。尽管中位年龄从44岁增加到53岁,但从1994年到2005年,化疗敏感的复发性NHL患者的OS有显着改善(第+100天OS:85至96%; 1年OS:68至80% P<0.001)和化疗敏感性MM(第+100天OS:96至98%; 1年OS:83至92% P<0.001)。OS改善在中年(>40岁)和老年(>60岁)个体中最为明显。
Autologous hematopoietic cell transplantation (autoHCT) is used for relapsed and recurrent malignant disorders and as part of initial therapy for selected malignancies. This study describes changes in utilization, techniques and survival in a population–based cohort including 68,404 patients who underwent first autoHCT in a US or Canadian center, 1994–2005, and were reported to the Center for International Blood and Marrow Transplant Research (CIBMTR). The highest annual mean autoHCTs performed (average 6,948 annually) occurred during 1996–1999, with a subsequent decrease (average 4,783 annually), mainly due to less autoHCTs for breast cancer. However, the annual mean of autoHCTs increased from 5,278 annually in 1994–1995 to 5,459 annually in 2004–2005, reflecting increased utilization for multiple myeloma (MM), non-Hodgkin (NHL) and Hodgkin lymphoma (HL). Despite an increase in the median age from 44 to 53 years, there has been a significant improvement in OS from 1994 to 2005 for patients with chemotherapy-sensitive relapsed NHL (Day +100 OS: 85 to 96%; 1 year OS: 68 to 80% P<0.001) and chemotherapy-sensitive MM (Day +100 OS: 96 to 98%; 1 year OS: 83 to 92% P<0.001). The OS improvement was most pronounced in middle aged (>40 years) and older (>60 years) individuals.
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