Bone Marrow Transplantation for Acute Lymphoblastic Leukemia in Children
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概要
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We review our experience with BMT for ALL in children. Ninety-six patients aged 1 to 18 years underwent BMT. The allogeneic (Allo) BMT group consisted of 65 patients, including 8 with matched unrelated donors; 31 underwent autologous (Auto) BMT. Thirty patients received transplants during first complete remission (CR), 41 during second CR, and 25 during other stages. Conditioning regimens consisted of cyclophosphamide (CY) plus total body irradiation (TBI) ±otheragents (<I>n</I>=22);melphalan (L-PAM) plusTBI ± other agents (<I>n</I>=60); and L-PAM and busulfan (<I>n</I>=14). Prophylaxis for graft-versus-host disease (GVHD) consisted of methotrexate (MTX) alone for two months (<I>n</I>=40) or short-term MTX with cyclosporine (<I>n</I>=23). Two patients received cyclosporine alone. When hematopoietic recovery was compared, allo-BMT and autoBMT had similar granulocyte engraftment, but the recovery of platelets and reticulocytes was significantly faster in allo-BMT. Acute GVHD exceeding grade 2 was documented in 13% of allo-BMT and chronic GVHD was observed in 29%. Thirty-eight patients (40%) died; 16 patients died of relapse. The 5-year disease-free survival (DFS) rate for all patients and that for transplantations in first CR, second CR, and other stages was 59.6%, 83.3%, 61%, and 24.6%, respectively. DFS rates were not different between allo-BMT and auto-BMT in each group. When patients receiving L-PAM were compared with those receiving CY, more patients receiving transplantations in second CR who were conditioned with a regimen including L-PAM had prolonged DFS (71.4%) as compared With the CY group (40%).
- 特定非営利活動法人 日本小児血液・がん学会の論文
特定非営利活動法人 日本小児血液・がん学会 | 論文
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