Allogeneic hemopoietic stem cell transplants for patients with relapsed acute leukemia: Long-term outcome

A. Bacigalupo, T. Lamparelli, F. Gualandi, D. Occhini, S. Bregante, A. M. Raiola, A. Ibatici, C. di Grazia, A. Dominietto, G. Piaggio, M. Podesta, B. Bruno, A. Lombardi, F. Frassoni, C. Viscoli, N. Sacchi, M. T. Van Lint

Research output: Contribution to journalArticle

Abstract

We assessed the long-term outcome of patients with relapsed acute myeloid (n=86) or acute lymphoid leukemia (n=66), undergoing an allogeneic hemopoietic stem cell transplantation in our unit. The median blast count in the marrow was 30%. Conditioning regimen included total body irradiation (TBI) (10-12Gy) in 115 patients. The donor was a matched donor (n = 132) or a family mismatched donor (n = 20). Twenty-two patients (15%) survive disease free, with a median follow-up of 14 years: 18 are off medications. The cumulative incidence of transplant related mortality is 40% and the cumulative incidence of relapse related death (RRD) is 45%. In multivariate analysis of survival, favorable predictors were chronic graft-versus-host disease (GvHD) (P = 0.0003), donor other than family mismatched (P = 0.02), donor age less than 34 years (P=0.02) and blast count less than 30% (P = 0.07). Patients with all four favorable predictors had a 54% survival. In multivariate analysis of relapse, protective variables were the use of TBI (P = 0.005) and cGvHD (P = 0.01). This study confirms that a fraction of relapsed leukemias is cured with an allogeneic transplant: selection of patients with a blast count

Original languageEnglish
Pages (from-to)341-346
Number of pages6
JournalBone Marrow Transplantation
Volume39
Issue number6
DOIs
Publication statusPublished - Mar 2007

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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