By Mary J. Laughlin, Hillard M. Lazarus
Across the world well-known physicians and researchers evaluate either the fundamentals of allogeneic stem mobile transplantation and up to date advances within the box, quite as they relate to antitumor results and graft-versus-host disorder in addition they offer specified decision-tree analyses to lead clinicians in deciding on and coping with their allogeneic transplant sufferers. The suggestions mentioned conceal quite a few parts, starting from stem phone mobilization in basic donors, to symptoms for allogeneic transplantation except hematologic malignancies, to using nonmyeloablative conditioning regimens. The authors additionally discover new advancements within the optimum collection of unrelated allogeneic grafts (e.g., matched unrelated donor, in part mismatched loved one, or umbilical wire blood), the use allogeneic peripheral blood stem mobilephone vs marrow-derived grafts for transplantation, and the kinetics of immune reconstitution after transplantation.
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Extra info for Allogeneic Stem Cell Transplantation (Current Clinical Oncology)
The DFS for patients treated with conventional chemotherapy ranges from 30 to 40%. The large difference in outcome of patients entered onto these small phase II studies is influenced by multiple variables, including differences in patient 34 Part II / Disease Indications: Allogeneic Transplantation Table 3 Allogeneic Transplantation for ALL in CR1 No. of Median patients age (yr) Study Wingard, 1990 (20) Blaise, 1990 (21) 18 25 Chao, 1991 (22) 53 Doney, 1991 (23) 41 Sutton, 1993 (24) 184 (retrospective review) Vey, 1994 (25) 29 DeWitte, 1994 (26) 22 Prep.
A second study with 22 patients (five patients with ALL) with refractory disease had a similar survival of 38% following HLAmatched sibling transplants. Other studies suggest lower survival rates of 20% or less for these refractory patients (32,34); nevertheless, allogeneic transplant should be considered for these patients with an otherwise dismal chance of long-term survival. 6. PHILADELPHIA CHROMOSOME-POSITIVE ALL The presence of the Philadelphia chromosome (Ph) represents an independent adverse risk factor, and carries an exceptionally poor prognosis.
Blood 1996;88:142a. 71. Andersson BS, Kashyap A, Gian V, et al. Conditioning therapy with intravenous busulfan and cyclophosphamide (IV BuCy2) for hematologic malignancies prior to allogeneic stem cell transplantation: a phase II study. Biol Blood Marrow Transplant 2002;3:145–154. 72. Deeg HJ, Shulman HM, Anderson JE, et al. Allogeneic and syngeneic marrow transplantation for myelodysplastic syndrome in patients 55 to 66 years of age. Blood 2000;95:1188–1194. 28 Part II / Disease Indications: Allogeneic Transplantation Chapter 3 / Stem Cell Transplantation for ALL 3 29 Allogeneic Stem Cell Transplantation for Adult Acute Lymphoblastic Leukemia Partow Kebriaei, MD and Wendy Stock, MD CONTENTS INTRODUCTION PROGNOSTIC FACTORS IN ADULT ALL ALLOGENEIC TRANSPLANTATION FOR HIGH-RISK ALL DURING FIRST CR ALLOGENEIC TRANPLANTATION BEYOND CR1 USING HLA-IDENTIFIED SIBLING DONORS PRIMARY REFRACTORY ALL PHILADELPHIA CHROMOSOME-POSITIVE ALL FACTORS INFLUENCING TRANSPLANT OUTCOME LONG-TERM COMPLICATIONS OF ALLOGENEIC TRANSPLANTATION NOVEL TRANSPLANT APPROACHES REFERENCES 1.