BONE-MARROW TRANSPLANTATION FOR CHRONIC MYELOGENOUS LEUKEMIA IN CHRONIC PHASE - INCREASED RISK FOR RELAPSE ASSOCIATED WITH T-CELL DEPLETION
BONE-MARROW TRANSPLANTATION FOR CHRONIC MYELOGENOUS LEUKEMIA IN CHRONIC PHASE - INCREASED RISK FOR RELAPSE ASSOCIATED WITH T-CELL DEPLETION
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DOI：
10.7326/0003-4819-108-6-806
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发表时间：
1988-06-01
影响因子：
39.2
通讯作者：
BORTIN, MM
中科院分区：
文献类型：
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作者：
GOLDMAN, JM;GALE, RP;BORTIN, MM
对405例慢性期接受骨髓移植的慢性粒细胞白血病患者的资料进行了分析，以寻找预后的预测因素。4年复发的精算概率为19%（95%置信区间[CI]，12%至28%），生存率为55%（95% CI，50%至60%）。在多变量分析中，与非T细胞耗竭骨髓受体相比，T细胞耗竭骨髓受体的复发概率更高（相对危险度，5.4; P < 0.0001），未发生慢性移植物抗宿主病的患者与发生慢性移植物抗宿主病的患者相比（相对危险度，3.1; P < 0.01）。发生中度至重度急性移植物抗宿主病的患者的生存概率低于无或轻度急性移植物抗宿主病的患者（相对风险，3.7; P < 0.0001），20岁或以上的患者的生存概率低于年轻患者（相对风险，2.6; P < 0.0002）。移植前疾病持续时间与结果无关。在慢性粒细胞白血病的慢性期进行骨髓移植可以延长一些患者的无白血病生存期。T细胞耗尽的移植物与复发的可能性增加有关。
Data on 405 patients with chronic myelogenous leukemia who received bone marrow transplants in chronic phase were analyzed for factors predictive of outcome. The 4-year actuarial probability of relapse was 19% (95% confidence interval [CI], 12% to 28%) and of survival, 55% (95% CI, 50% to 60%). In multivariate analyses the probability of relapse was higher for recipients of T-cell-depleted bone marrow compared with recipients of non-T-cell-depleted bone marrow (relative risk, 5.4; P < 0.0001) and for patients who did not develop chronic graft-versus-host disease with patients who did (relative risk, 3.1; P < 0.01). The probability of survival was lower for patients who developed moderate to severe acute graft-versus-host disease than for patients with no or mild acute graft-versus-host disease (relative risk, 3.7; P < 0.0001), and in patients aged 20 or older than in younger patients (relative risk, 2.6; P < 0.0002). Duration of disease before transplant was not associated with outcome. Bone marrow transplantation done in the chronic phase of chronic myelogenous leukemia offers some patients prolonged leukemia-free survival. The T-cell-depleted grafts are associated with an increased probability of relapse.