Allogeneic bone marrow transplantation for acute leukemia in patients over the age of 40 years
Allogeneic bone marrow transplantation for acute leukemia in patients over the age of 40 years
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DOI：
10.1038/sj.leu.2400573
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发表时间：
1997-03-01
期刊：
影响因子：
11.4
通讯作者：
Gorin, NC
中科院分区：
文献类型：
--
作者：
Cahn, JY;Labopin, M;Gorin, NC
由于移植相关死亡和移植物抗宿主病的高风险，将同种异体移植扩展到老年患者受到限制。为了评估老年患者的可行性，对192例年龄在40岁以上的首次缓解急性白血病患者进行了回顾性分析，并与1986年至1992年EBMT报告的1119例年龄在16至40岁之间的受者进行了比较。采用卡方（2）统计方法比较两个年龄组的患者、疾病和治疗相关变量。多变量分析包括差异显著或被认为是潜在预后因素的变量。两种类型白血病的无白血病生存率和复发率在不同年龄组之间具有可比性。年龄较大的ALL患者中移植物抗宿主病的发病率较高。首次缓解的老年AML患者治疗相关死亡率较高，但对生存率无影响。AML患者的配对分析未显示两个年龄组患者的LFS、RI、TRM和生存率的概率存在任何统计学差异。这些结果表明，BMT应考虑40岁以上的患者。
Extension of allogeneic transplants to older patients has been limited by a high risk of transplant-related death and graft-versus-host disease. To evaluate the feasibility in older patients, a retrospective analysis of the procedure was performed for first remission acute leukemia in 192 patients aged over 40 years and compared with a group of 1119 recipients aged from 16 to 40 years reported to the EBMT from 1986 to 1992. Patient-, disease-, and treatment-related variables were compared between the two age groups using the chi(2) statistical method for categorical variables. Variables differing significantly or recognized as potential prognostic factors were included in a multivariate analysis. Leukemia-free survival and relapse were comparable among the age groups in the two types of leukemias. Incidence of graft-versus-host disease was higher in the older group of ALL patients. Older patients with AML in first remission had a higher treatment-related mortality incidence, with no influence on survival. A pair-matched analysis of AML patients did not show any statistical difference in the probability of LFS, RI, TRM, and survival for the two age cohorts of patients. These results suggest that BMT should be considered for patients over 40 years of age.