Interferon- Before Allogeneic Bone Marrow Transplantation in Chronic Myelogenous Leukemia Does Not Affect Outcome Adversely, Provided It Is Discontinued at Least 90 Days Before the Procedure
Interferon- Before Allogeneic Bone Marrow Transplantation in Chronic Myelogenous Leukemia Does Not Affect Outcome Adversely, Provided It Is Discontinued at Least 90 Days Before the Procedure
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慢性粒细胞白血病同种异体骨髓移植前使用干扰素不会对结果产生不利影响，前提是在手术前至少 90 天停止使用干扰素
DOI：
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发表时间：
1999
期刊：
影响因子：
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通讯作者：
A. Tobler
中科院分区：
文献类型：
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作者：
Rüdiger Hehlmann;A. Hochhaus;H. Kolb;J. Hasford;A. Gratwohl;Hermann Heimpel;W. Siegert;J. Finke;G. Ehninger;E. Holler;U. Berger;M. Pfirrmann;A. Muth;A. Zander;A. Fauser;A. Heyll;C. Nerl;D. Hossfeld;H. Löffler;Hans Pralle;W. Queisser;A. Tobler
α干扰素（IFN）预处理对慢性粒细胞白血病（CML）异基因骨髓移植（BMT）后结局的影响存在争议。德国CML随机研究I和II的一个目的是比较IFN +/-化疗与单独化疗，分析IFN治疗与化疗相比是否对BMT后的结局有影响。856例Ph/bcr-abl阳性CML患者中有197例（23%）接受了移植。分析了152例第一慢性期移植患者：86例接受了IFN，46例接受了羟基脲，20例接受了白消安。48名患者（32%）接受了无关供体的移植。BMT后的中位观察时间为4.7（0.7 - 13.5）年。比较了IFN和化疗队列的移植风险、治疗持续时间、从移植前治疗停止到BMT的间隔、预处理治疗、移植物抗宿主病预防和诊断和移植时的风险特征，IFN队列还比较了IFN的性能和耐药性。接受相关或不相关移植的患者接受干扰素、羟基脲或白消安预处理的结果没有显著差异。所有患者移植后5年生存率为58%（IFN组为57%，羟基脲和白消安组为60%）。IFN组内的结果是没有不同的持续时间之前的IFN治疗超过或少于5个月，1年，或2年。相反，在IFN预处理的患者中观察到不同的影响，这取决于移植前停用IFN的时间。在骨髓移植前90天内接受干扰素治疗的50例患者的5年生存率为46%，而未接受干扰素治疗的36例患者的5年生存率为71%（P = 0.0057）。总IFN剂量对BMT后生存率无影响。我们的结论是，骨髓移植后的结果是不会受到干扰素预处理，如果它是在移植前至少3个月停止。明确的早期移植候选者不应用IFN预处理。
The influence of interferon-alpha (IFN) pretreatment on the outcome after allogeneic bone marrow transplantation (BMT) in chronic myelogenous leukemia (CML) is controversial. One goal of the German randomized CML Studies I and II, which compare IFN +/- chemotherapy versus chemotherapy alone, was the analysis of whether treatment with IFN as compared to chemotherapy had an influence on the outcome after BMT. One hundred ninety-seven (23%) of 856 Ph/bcr-abl-positive CML patients were transplanted. One hundred fifty-two patients transplanted in first chronic phase were analyzed: 86 had received IFN, 46 hydroxyurea, and 20 busulfan. Forty-eight patients (32%) had received transplants from unrelated donors. Median observation time after BMT was 4.7 (0.7 to 13.5) years. IFN and chemotherapy cohorts were compared with regard to transplantation risks, duration of treatments, interval from discontinuation of pretransplant treatment to BMT, conditioning therapy, graft-versus-host disease prophylaxis and risk profiles at diagnosis and transplantation, and IFN cohorts also with regard to performance and resistance to IFN. Outcome of patients receiving related or unrelated transplants pretreated with IFN, hydroxyurea, or busulfan was not significantly different. Five-year survival after transplantation was 58% for all patients (57% for IFN, 60% for hydroxyurea and busulfan patients). The outcome within the IFN group was not different by duration of prior IFN therapy more or less than 5 months, 1 year, or 2 years. In contrast, a different impact was observed in IFN-pretreated patients depending on the time of discontinuation of IFN before transplantation. Five-year survival was 46% for the 50 patients who received IFN within the last 90 days before BMT and 71% for the 36 patients who did not (P =.0057). Total IFN dosage had no impact on survival after BMT. We conclude that outcome after BMT is not compromised by pretreatment with IFN if it is discontinued at least 3 months before transplantation. Clear candidates for early transplantation should not be pretreated with IFN.
骨髓移植与羟基脲或干扰素治疗慢性粒细胞白血病的生存率。
影响因子：
20.3
作者：
Gale,RP;Hehlmann,R;Zhang,MJ;Hasford,J;Goldman,JM;Heimpel,H;Hochhaus,A;Klein,JP;Kolb,HJ;McGlave,PB;Passweg,JR;Rowlings,PA;Sobocinski,KA;Horowitz,MM
通讯作者：
Horowitz,MM