Allogeneic bone marrow transplantation in first remission for children with very high-risk acute lymphoblastic leukemia: a retrospective case-control study in the Nordic countries. Nordic Society for Pediatric Hematology and Oncology (NOPHO).
Allogeneic bone marrow transplantation in first remission for children with very high-risk acute lymphoblastic leukemia: a retrospective case-control study in the Nordic countries. Nordic Society for Pediatric Hematology and Oncology (NOPHO).
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极高危急性淋巴细胞白血病儿童首次缓解时的同种异体骨髓移植：北欧国家的一项回顾性病例对照研究。
DOI：
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发表时间：
1996
影响因子：
4.8
通讯作者：
G. Gustafsson
中科院分区：
文献类型：
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作者：
U. Saarinen;L. Mellander;K. Nysom;O. Ringdén;H. Schroeder;A. Glomstein;G. Gustafsson
在高危（HR）ALL儿童中，尽管儿童ALL的常规化疗取得了进展，但仍存在具有极高危（VHR）特征和预后不良的亚组。我们在一项回顾性病例对照研究中评估了接受异基因BMT（allo-BMT）首次缓解（1CR）的儿童VHR-ALL的结局。在五个北欧国家的基于人群的ALL材料中，22名VHR-ALL儿童在1981-1991年间在1CR中接受了allo-BMT。我们比较了这22名儿童与44名密切匹配的对照患者的结果，这些患者接受了HR-ALL方案的常规化疗，以及代表Nordic ALL数据库中剩余HR-ALL患者的405名儿童。在1CR中接受allo-BMT的儿童的10年无病生存率为73%，匹配对照组为50%（P = 0.02），其余HR-ALL患者为59%。allo-BMT组的良好预后是由于9%的低复发率，而匹配对照组的复发率为41%。allo-BMT治疗1CR的优势主要表现在诊断时WBC>或= 100 × 10（9）/l的患者中; allo-BMT组9/10存活，而对照组8/20存活（P = 0.03）。我们的结论是，对于具有匹配的同胞供体和WBC>或= 100的VHR-ALL和其他已建立的VHR标准的儿童，应认真考虑1CR中的allo-BMT。
Among children with high-risk (HR) ALL there are subgroups with very-high-risk (VHR) features and poor prognosis despite developments in conventional chemotherapy for childhood ALL. We evaluated the outcome of VHR-ALL in children receiving allogeneic BMT (allo-BMT) in first remission (1CR) in a retrospective case-control study. In the population-based ALL material of the five Nordic countries, 22 children with VHR-ALL have undergone allo-BMT in 1CR between 1981-1991. We compared the outcome in these 22 children with 44 closely matched control patients who received conventional chemotherapy on HR-ALL protocols, as well as with a group of 405 children representing the remaining HR-ALL patients in the Nordic ALL database. The disease-free survival at 10 years was 73% in children receiving allo-BMT in 1CR, 50% in the matched controls (P = 0.02), and 59% in the remaining HR-ALL patients. The good prognosis of the allo-BMT group was due to a low relapse rate of 9%, as opposed to 41% in the group of matched controls. The superiority of allo-BMT as therapy in 1CR was mainly apparent in those with a very high WBC of > or = 100 x 10(9)/I at diagnosis; in the allo-BMT group 9/10 survived, as opposed to 8/20 of the matched controls (P = 0.03). We conclude that allo-BMT in 1CR should be seriously considered for children with a matched sibling donor and a VHR-ALL with WBC of > or = 100 and other established VHR criteria.