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A long-term follow-up report on allogeneic stem cell transplantation for patients with primary refractory acute myelogenous leukemia: impact of cytogenetic characteristics on transplantation outcome
- Source :
- Biology of Blood and Marrow Transplantation. 9(12):766-771
- Publication Year :
- 2003
- Publisher :
- Elsevier BV, 2003.
-
Abstract
- The prognosis of patients with primary refractory acute myelogenous leukemia (AML) is poor. Our initial report suggested that some patients could achieve durable remission after allogeneic stem cell transplantation (SCT). Herein, we update our initial experience and report further analysis of this group of patients to determine whether there are pre-SCT prognostic factors predictive of posttransplantation relapse and survival. We reviewed the records of 68 patients who consecutively underwent transplantation at the City of Hope Cancer Center with allogeneic SCT for primary refractory AML between July 1978 and August 2000. Potential factors associated with overall survival and disease-free survival were examined. With a median follow-up of 3 years, the 3-year cumulative probabilities of disease-free survival (DFS), overall survival (OS), and relapse rate for all 68 patients were 31% (95% confidence interval [CI], 20%–42%), 30% (95% CI, 18%–41%), and 51% (95% CI, 38%–65%), respectively. In multivariate analysis, the only variables associated with shortened OS and DFS included the use of an unrelated donor as the stem cell source (relative risk, 2.23 [OS] and 2.05 [DFS]; P = .0005 and .0014, respectively) and unfavorable cytogenetics before SCT (relative risk: 1.68 [OS] and 1.58 [DFS]; P = .0107 and .0038, respectively). Allogeneic SCT can cure approximately one third of patients with primary refractory AML. Cytogenetic characteristics before SCT correlate with transplantation outcome and posttransplantation relapse.
- Subjects :
- Adult
Male
Oncology
medicine.medical_specialty
Myeloid
Adolescent
Acute myelogenous leukemia
Salvage therapy
Myelogenous
Refractory
Risk Factors
hemic and lymphatic diseases
Internal medicine
Humans
Transplantation, Homologous
Medicine
Child
Survival analysis
Bone Marrow Transplantation
Retrospective Studies
Salvage Therapy
Transplantation
business.industry
Hematopoietic Stem Cell Transplantation
Retrospective cohort study
Hematology
Middle Aged
Prognosis
Cytogenetic characteristics
medicine.disease
Survival Analysis
Allogeneic stem cell transplantation
Surgery
Leukemia, Myeloid, Acute
Leukemia
Treatment Outcome
surgical procedures, operative
medicine.anatomical_structure
Treatment failure
Child, Preschool
Cytogenetic Analysis
Female
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 10838791
- Volume :
- 9
- Issue :
- 12
- Database :
- OpenAIRE
- Journal :
- Biology of Blood and Marrow Transplantation
- Accession number :
- edsair.doi.dedup.....b2cc6d36cf20e494204add9c583bc1df
- Full Text :
- https://doi.org/10.1016/j.bbmt.2003.08.004