Unrelated bone marrow transplantation in patients with myelodysplastic syndromes and secondary acute myeloid leukemia: an EBMT survey
Unrelated bone marrow transplantation in patients with myelodysplastic syndromes and secondary acute myeloid leukemia: an EBMT survey
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DOI：
10.1038/sj.bmt.1701269
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发表时间：
1998-06-01
影响因子：
4.8
通讯作者：
Apperley, JF
中科院分区：
文献类型：
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作者：
Arnold, R;de Witte, T;Apperley, JF
EBMT的慢性白血病工作组收集了118例患者的数据，患者的中位年龄为24岁。（范围0.3 - 53岁），接受了来自无关供体的同种异体骨髓移植治疗MDS或继发性AML（RA/RARS，n = 24; RAEB，n = 26; RAEB-t，n = 34; CMML，n = 12; sAML，n = 22）1986年至1996年间，数据由49个EBMT中心报告。118例患者中有34例存活，复发是84例患者中19例死亡的原因，其余患者死于移植相关死亡。全组2年生存率为28%，无病生存率为28%，复发率为35%，移植相关死亡率为58%，受者年龄对移植相关死亡率有显著影响骨髓移植后复发率受骨髓移植时疾病的FAB分类的影响，原始细胞计数低的患者（RA、RAEB）复发概率较低（13%，15%）与RAEB-t或sAML患者相比（29%，45%），此外，我们发现MDS/sAML患者中移植物抗白血病效应的证据，急性GVHD患者，II-IV级，复发概率为26%，而无急性GVHD或仅I级的患者复发概率为42%。与HLA匹配的无关供体的同种异体移植可提供给年轻患者（年龄
The Chronic Leukemia Working Party of the EBMT has collected data on 118 patients of median age 24 years (range 0.3 to 53 years) who underwent an allogeneic bone marrow transplantation from unrelated donors for treatment of MDS or secondary AML (RA/RARS, n = 24; RAEB, n = 26; RAEB-t, n = 34; CMML, n = 12; sAML, n = 22) between 1986 and 1996, The data were reported by 49 EBMT centers. Thirty-four of 118 patients are alive, relapse was the cause of death in 19 of 84 patients and the remaining patients died of transplant-related mortality. For the whole group the actuarial probability of survival at 2 years is 28%, disease-free survival 28%, relapse risk 35% and transplant-related mortality is 58%, The transplant-related mortality is significantly influenced by the age of the recipient (35 years 81%), The relapse rate after BMT is influenced by FAB classification of the disease at BMT, Patients with a low blast count (RA, RAEB) have a lower probability of relapse (13%, 15%) compared to patients with RAEB-t or sAML (29%, 45%), Furthermore, we found evidence of a graft-versus-leukemia effect in MDS/sAML, Patients with acute GVHD, grade II-IV, had a probability of relapse of 26% vs 42% in patients with no acute GVHD or grade I only. Allogeneic transplantation with an HLA-matched, unrelated donor may be offered to younger patients (age