Central nervous system relapse of leukemia after allogeneic hematopoietic stem cell transplantation

被引：66

作者：

Oshima, Kumi

Kanda, Yoshinobu ^{[1
]}

Yamashita, Takuya ^{[2
]}

Takahashi, Satoshi ^{[3
]}

Mori, Takehiko ^{[4
]}

Nakaseko, Chiaki ^{[5
]}

Fujimaki, Katsumichi ^{[6
]}

Yokota, Akira ^{[7
]}

Fujisawa, Shin ^{[8
]}

Matsushima, Takafumi ^{[9
]}

Fujita, Hiroyuki ^{[10
]}

Sakura, Tohru ^{[11
]}

Okamoto, Shinichiro ^{[4
]}

Maruta, Atsuo ^{[12
]}

Sakamaki, Hisashi ^{[2
]}

机构：

[1] Jichi Med Univ, Saitama Med Ctr, Div Hematol, Omiya Ku, Saitama 3308503, Japan

[2] Tokyo Metropolitan Komagome Hosp, Div Hematol, Tokyo, Japan

[3] Univ Tokyo, Inst Med Sci, Adv Clin Res Ctr, Div Mol Therapy, Tokyo, Japan

[4] Keio Univ, Sch Med, Dept Med, Div Hematol, Tokyo 160, Japan

[5] Chiba Univ, Sch Med, Dept Hematol, Chiba 280, Japan

[6] Yokohama City Univ, Grad Sch Med, Dept Internal Med & Clin Immunol, Kanagawa, Japan

[7] Chiba Aoba Municipal Hosp, Dept Internal Med, Chiba, Japan

[8] Yokohama City Univ, Med Ctr, Dept Hematol, Kanagawa, Japan

[9] Gunma Univ, Grad Sch Med, Dept Med & Clin Sci, Gunma, Japan

[10] Shizuoka Red Cross Hosp, Div Hematol, Shizuoka, Japan

[11] Saiseikai Maebashi Hosp, Div Hematol, Gunma, Japan

[12] Kanagawa Canc Ctr, Dept Hematol, Kanagawa, Japan

来源：

BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION | 2008年 / 14卷 / 10期

关键词：

leukemia; central nervous system; relapse; allogeneic hematopoietic stem cell transplantation;

D O I：

10.1016/j.bbmt.2008.07.002

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Little information is available regarding central nervous system (CNS) relapse of adult leukemia after allogeneic hematopoietic stem cell transplantation (HSCT). Therefore, we reviewed the data of 1226 patients with acute myelogenous leukemia (AML), acute lymphoblastic leukemia (ALL), and chronic myelogenous leukemia (CML) who received first allogeneic HSCT between 1994 and 2004, using the database of the Kanto Study Group for Cell Therapy (KSGCT), and analyzed the incidence, risk factors, and outcome of patients with CNS relapse. Twenty-nine patients developed CNS relapse at a median of 296 (9-1677) days after HSCT with a cumulative incidence of 2.3%. Independent significant factors associated with CNS relapse included ALL as the underlying diagnosis (relative risk [RR] = 9.55, 95% confidence interval [CI] = 1.26-72.2, P =.029), nonremission at HSCT (RR = 2.30, 95% CI = 1.03-5.15, P =.042), the history of CNS invasion before HSCT (RR 5.62,95% CI = 2.62-12.0, P = 9.2 x 10(-6)), and the prophylactic intrathecal chemotherapy after HSCT (RR 2.57, 95% CI = 1.21-5.46, P = .014). The 3-year overall survival (OS) after CNS relapse was 18%. In 7 of 29 patients with CNS relapse, leukemia was observed only in CNS. Three of 7 patients were alive without systemic relapse, resulting in 3-year survival after CNS relapse of 46%. Although the outcome of patients with CNS relapse was generally poor, long-term disease-free survival could be achieved in some patients.

引用

页码：1100 / 1107

页数：8

共 18 条

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