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Article: Primary treatment of leukemia relapses after allogeneic hematopoietic stem cell transplantation with reduced-intensity conditioning second transplantation from the original donor

TitlePrimary treatment of leukemia relapses after allogeneic hematopoietic stem cell transplantation with reduced-intensity conditioning second transplantation from the original donor
Authors
Issue Date2013
Citation
American Journal of Hematology, 2013, v. 88, n. 6, p. 485-491 How to Cite?
AbstractAcute leukemia relapsing after allogeneic hematopoietic stem cell transplantation (HSCT) has dismal outcome. Consecutive consenting patients (acute myeloid leukemia: N=71; acute lymphoblastic leukemia: N=37), at a median age of 37 (16-57) years, who had relapsed 7.9 (1.3-132) months post-HSCT, were treated with three cytarabine-based intensive regimens as reduced-intensity conditioning (RIC), followed by infusion of mobilized HSC from the original donors. There were four treatment-related mortalities (TRMs). Of 104 evaluable cases, 72 patients (67%) achieved complete remission (CR)/CR with incomplete hematologic recovery (CRi). The median overall survival (OS) of the entire cohort was 11.6 months. The OS of patients achieving CR/CRi after the first RIC/HSCT was 18.8 months, as compared with 3.9 months for those not (P<0.01). For 32 patients with nonremission, 11 received a repeat RIC-HSCT, leading to CR/CRi in three cases. Therefore, 75/108 (69%) of patients achieved CR/CRi after one or two courses of RIC-HSCT. Among CR/CRi patients, 48 cases relapsed again after 6.1 (1.0-64.4) months. Thirty cases received a repeat RIC-HSCT, leading to CR/CRi in 22 patients. Multivariate analyses showed a significant impact of remission duration after initial HSCT (P=0.026) and the presence of acute graft-versus-host disease after RIC-HSCT (P=0.011) on CR/CRi. RIC-HSCT as primary treatment for acute leukemic relapses post-HSCT induced a high CR rate with low TRM. Optimal postremission treatment remains to be defined. © 2013 Wiley Periodicals, Inc.
Persistent Identifierhttp://hdl.handle.net/10722/200134
ISSN
2015 Impact Factor: 5.0
2015 SCImago Journal Rankings: 1.761
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLeung, Anska Y H-
dc.contributor.authorTse, Eric-
dc.contributor.authorHwang, Yuyan-
dc.contributor.authorChan, Thomas S Y-
dc.contributor.authorGill, Harinder-
dc.contributor.authorChim, James C S-
dc.contributor.authorLie, Albert-
dc.contributor.authorKwong, Yok Lam-
dc.date.accessioned2014-07-26T23:11:10Z-
dc.date.available2014-07-26T23:11:10Z-
dc.date.issued2013-
dc.identifier.citationAmerican Journal of Hematology, 2013, v. 88, n. 6, p. 485-491-
dc.identifier.issn0361-8609-
dc.identifier.urihttp://hdl.handle.net/10722/200134-
dc.description.abstractAcute leukemia relapsing after allogeneic hematopoietic stem cell transplantation (HSCT) has dismal outcome. Consecutive consenting patients (acute myeloid leukemia: N=71; acute lymphoblastic leukemia: N=37), at a median age of 37 (16-57) years, who had relapsed 7.9 (1.3-132) months post-HSCT, were treated with three cytarabine-based intensive regimens as reduced-intensity conditioning (RIC), followed by infusion of mobilized HSC from the original donors. There were four treatment-related mortalities (TRMs). Of 104 evaluable cases, 72 patients (67%) achieved complete remission (CR)/CR with incomplete hematologic recovery (CRi). The median overall survival (OS) of the entire cohort was 11.6 months. The OS of patients achieving CR/CRi after the first RIC/HSCT was 18.8 months, as compared with 3.9 months for those not (P<0.01). For 32 patients with nonremission, 11 received a repeat RIC-HSCT, leading to CR/CRi in three cases. Therefore, 75/108 (69%) of patients achieved CR/CRi after one or two courses of RIC-HSCT. Among CR/CRi patients, 48 cases relapsed again after 6.1 (1.0-64.4) months. Thirty cases received a repeat RIC-HSCT, leading to CR/CRi in 22 patients. Multivariate analyses showed a significant impact of remission duration after initial HSCT (P=0.026) and the presence of acute graft-versus-host disease after RIC-HSCT (P=0.011) on CR/CRi. RIC-HSCT as primary treatment for acute leukemic relapses post-HSCT induced a high CR rate with low TRM. Optimal postremission treatment remains to be defined. © 2013 Wiley Periodicals, Inc.-
dc.languageeng-
dc.relation.ispartofAmerican Journal of Hematology-
dc.titlePrimary treatment of leukemia relapses after allogeneic hematopoietic stem cell transplantation with reduced-intensity conditioning second transplantation from the original donor-
dc.typeArticle-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1002/ajh.23439-
dc.identifier.pmid23512868-
dc.identifier.scopuseid_2-s2.0-84878189853-
dc.identifier.hkuros218621-
dc.identifier.hkuros213810-
dc.identifier.volume88-
dc.identifier.issue6-
dc.identifier.spage485-
dc.identifier.epage491-
dc.identifier.eissn1096-8652-
dc.identifier.isiWOS:000319293000007-

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