Intensive Therapy Followed by Bone Marrow Transplantation for Patients With Acute Lymphocytic Leukemia in Second or Subsequent Remission: Determination of Prognostic Factors
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چکیده
Fifteen patients with acute lymphocytic leukemia (ALL) in second or subsequent remission received intensive therapy with cyclophosphamide and single dose. rapid rate (26 cGy/min) total body irradiation (TBI) followed by bone marrow transplantation (BMT) from a histocompatible sibling match. Outcome was compared to that of 23 conventionally treated control patients in second ALL remission who presented to the same institution during the same time period but had no available transplant donor. The 1 5 BMT patients and 23 control patients had similar characteristics. with the exception that the BMT patients were significantly older at the time of ALL diagnosis (12.6 yr versus 5.7 yr. p = 0.01 ). BMT patients had a significantly increased chance of remaining disease-free for 36 mo from time on study (43% actuarial versus 5%. p = 0.004) and a greater overall survival rate at 48 mo (47% actuarial versus 9%. p = 0.27) than the conventionally treated patients. In all. 5 of the bone marrow transplant patients (33%) remain alive and free of disease 24-48 + mo from transplantation. Several preand posttransplant characteristics were analyzed to determine predictive factors for a successful BMT outcome for patients with ALL in second or subsequent remission. Significant risk factors for predicting leukemic
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تاریخ انتشار 2005