Bone marrow transplantation for therapy-induced acute myeloid leukemia in children with previous lymphoid malignancies
Bone marrow transplantation for therapy-induced acute myeloid leukemia in children with previous lymphoid malignancies
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DOI：
10.1038/sj.bmt.1701962
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发表时间：
1999-10-01
影响因子：
4.8
通讯作者：
Krance, RA
中科院分区：
文献类型：
--
作者：
Hale, GA;Heslop, HE;Krance, RA
1990年1月至1997年6月，21名儿童在急性淋巴细胞白血病治疗后发生治疗相关的急性髓细胞白血病，接受了异基因骨髓移植。所有患者以前都接受过含表鬼臼毒素的治疗方案，11例患者有涉及11 q23的细胞遗传学异常。13例患者接受诱导化疗，8例患者直接接受BMT，11例患者接受来自匹配同胞的骨髓，8例患者接受来自匹配无关供体的骨髓，2例患者接受来自半相合家庭成员的骨髓。预处理方案包括环磷酰胺（CY）、阿糖胞苷和全身照射。4例患者在BMT后1118至1825天内无病存活，3年DFS为19%。10例患者在BMT后中位数150天（范围30-664天）复发，最终均死于疾病，7例患者死于方案相关毒性。治疗相关AML/MDS患者的前景仍然不佳，需要更有效的治疗。
Twenty-one children who developed therapy-related acute myeloid leukemia after treatment for acute lymphoblastic leukemia received allogeneic bone marrow transplants between January 1990 and June 1997. All had previously received epipodophyllotoxin-containing regimens and 11 had cytogenetic abnormalities involving 11q23. Induction chemotherapy was given to 13 patients and eight patients went directly to BMT, Eleven received marrow from matched siblings, eight from matched unrelated donors and two from haploidentical family members. Conditioning regimens included cyclophosphamide (CY), cytarabine, and total body irradiation. Four patients are alive disease-free between 1118 and 1825 days post-BMT resulting in a 3-year DFS of 19%. Ten patients relapsed at a median of 150 days (range 30-664 days) post-BMT and all eventually died of disease, Seven patients died of regimen-related toxicity. The outlook for patients with therapy-related AML/MDS remains poor and more effective therapy is needed.