Clinical impact of graft-versus-host disease against leukemias not in remission at the time of allogeneic hematopoietic stem cell transplantation from related donors. The Japan Society for Hematopoietic Cell Transplantation Working Party

被引：23

作者：

Kataoka, I

Kami, M

Takahashi, S

Kodera, Y

Miyawaki, S

Hirabayashi, N

Okamoto, S

Matsumoto, N

Miyazaki, Y

Morishita, Y

Asai, O

Maruta, A

Yoshida, T

Imamura, M

Hamajima, N

Matsuo, K

Harada, M

Mineishi, S

机构：

[1] Vanderbilt Univ, Med Ctr, Hematol Hematopoiet Stem Cell Transplant Div, TVC 2665, Nashville, TN 37232 USA

[2] Natl Canc Ctr, Hematopoiet Stem Cell Transplant Unit, Chuo Ku, Tokyo, Japan

[3] Univ Tokyo, Inst Med Sci, Dept Hematol Oncol, Minato Ku, Tokyo, Japan

[4] Japanese Red Cross Nagoya First Hosp, Nakamura Ku, Nagoya, Aichi, Japan

[5] Saiseikai Maebashi Hosp, Gunma, Japan

[6] Nagoya Daini Red Cross Hosp, Dept Hematol, Showa Ku, Nagoya, Aichi, Japan

[7] Keio Univ, Sch Med, Dept Internal Med, Div Hematol,Shinjuku Ku, Tokyo, Japan

[8] Kansai Med Univ, Dept Internal Med 1, Osaka, Japan

[9] Nagasaki Univ, Grad Sch Biomed Sci, Atom Bomb Dis Inst, Dept Hematol,Mol Med Unit, Nagasaki 852, Japan

[10] JA Aichi Showa Hosp, Aichi, Japan

[11] Jikei Univ Hosp, Hematopoiet Cell Therapy Ctr, Minato Ku, Tokyo, Japan

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

[13] Toyama Prefectural Cent Hosp, Dept Internal Med, Toyama, Japan

[14] Hokkaido Univ, Grad Sch Med, Dept Hematol & Oncol, Kita Ku, Sapporo, Hokkaido, Japan

[15] Nagoya Univ, Grad Sch Med, Dept Prevent Med Biostat & Med Decis Making, Nagoya, Aichi, Japan

[16] Aichi Canc Ctr, Res Inst, Div Epidemiol & Prevent, Nagoya, Aichi 464, Japan

[17] Kyushu Univ, Grad Sch Med Sci, Dept Internal Med 1, Fukuska, Japan

来源：

BONE MARROW TRANSPLANTATION | 2004年 / 34卷 / 08期

关键词：

acute graft-versus-host disease; allogeneic transplantation; leukemia; nonremission;

D O I：

10.1038/sj.bmt.1704659

中图分类号：

Q6 [生物物理学];

学科分类号：

071011 ;

摘要：

Acute graft-versus-host disease (GVHD) increases posttransplant mortality and morbidity, but exerts a potent graft-versus-leukemia (GVL) effect. To clarify the impact of GVHD on outcome after transplant in aggressive diseases, patients with acute myeloid or lymphoblastic leukemia (AML, n = 366 or ALL, n = 255) in nonremission states, or chronic myelogenous leukemia (CML, n = 180) in accelerated phase (AP) or blastic crisis ( BC), who received allogeneic hematopoietic stem cell transplantation (HSCT) from a related donor between 1991 and 2000, were analyzed. Significant improvement in overall and disease-free survival (DFS) was detected with grade I acute GVHD in AML ( P = 0.0002 for overall survival and 0.0009 for DFS, respectively) and in CML ( P = 0.0256 and 0.0366, respectively), while the trend towards improved survival was observed in ALL. Relapse rate was lower in grade I acute GVHD than in grade II in all three diseases, suggesting that treatment for grade II GVHD may compromise the GVL effect associated with GVHD. Chronic GVHD was found to suppress relapse in CML and ALL, but not in AML, although no improvement in survival was observed in any disease category. Our results suggest that treatment for grade II acute GVHD may need to be attenuated in transplant for refractory leukemias.

引用

页码：711 / 719

页数：9

共 27 条

[1]

BARRETT AJ, 1989, BLOOD, V74, P862

[2] BONE-MARROW TRANSPLANTS MAY CURE PATIENTS WITH ACUTE-LEUKEMIA NEVER ACHIEVING REMISSION WITH CHEMOTHERAPY [J].

BIGGS, JC ;

HOROWITZ, MM ;

GALE, RP ;

ASH, RC ;

ATKINSON, K ;

HELBIG, W ;

JACOBSEN, N ;

PHILLIPS, GL ;

RIMM, AA ;

RINGDEN, O ;

ROZMAN, C ;

SOBOCINSKI, KA ;

VEUM, JA ;

BORTIN, MM .

BLOOD, 1992, 80 (04) :1090-1093

[3] MARROW TRANSPLANTATION FOLLOWING BUSULFAN AND CYCLOPHOSPHAMIDE FOR CHRONIC MYELOGENOUS LEUKEMIA IN ACCELERATED OR BLASTIC PHASE [J].

COPELAN, EA ;

GREVER, MR ;

KAPOOR, N ;

TUTSCHKA, PJ .

BRITISH JOURNAL OF HAEMATOLOGY, 1989, 71 (04) :487-491

[4]

FERRARA JLM, 1991, NEW ENGL J MED, V324, P667

[5] ALLOGENEIC BONE-MARROW TRANSPLANTATION AS THERAPY FOR PRIMARY INDUCTION FAILURE FOR PATIENTS WITH ACUTE-LEUKEMIA [J].

FORMAN, SJ ;

SCHMIDT, GM ;

NADEMANEE, AP ;

AMYLON, MD ;

CHAO, NJ ;

FAHEY, JL ;

KONRAD, PN ;

MARGOLIN, KA ;

NILAND, JC ;

ODONNELL, MR ;

PARKER, PM ;

SMITH, EP ;

SNYDER, DS ;

SOMLO, G ;

STEIN, AS ;

BLUME, KG .

JOURNAL OF CLINICAL ONCOLOGY, 1991, 9 (09) :1570-1574

[6] CLINICAL MANIFESTATIONS OF GRAFT VERSUS HOST DISEASE IN HUMAN RECIPIENTS OF MARROW FROM HL-A-MATCHED SIBLING DONORS [J].

GLUCKSBERG, H ;

STORB, R ;

FEFER, A ;

BUCKNER, CD ;

NEIMAN, PE ;

CLIFT, RA ;

LERNER, KG ;

THOMAS, ED .

TRANSPLANTATION, 1974, 18 (04) :295-304

[7] Graft-versus-host disease and outcome in HLA-identical sibling transplantations for chronic myeloid leukemia [J].

Gratwohl, A ;

Brand, R ;

Apperley, J ;

von Biezen, A ;

Bandini, G ;

Devergie, A ;

Schattenberg, A ;

Frassoni, F ;

Guglielmi, C ;

Iacobelli, S ;

Michallet, M ;

Kolb, HJ ;

Ruutu, T ;

Niederwieser, D .

BLOOD, 2002, 100 (12) :3877-3886

[8] ACUTE GRAFT-VERSUS-HOST DISEASE - GRADE AND OUTCOME IN PATIENTS WITH CHRONIC MYELOGENOUS LEUKEMIA [J].

GRATWOHL, A ;

HERMANS, J ;

APPERLEY, J ;

ARCESE, W ;

BACIGALUPO, A ;

BANDINI, G ;

DIBARTOLOMEO, P ;

BOOGAERTS, M ;

BOSI, A ;

CARRERAS, E ;

DEVERGIE, A ;

FERRANT, A ;

FIBBE, WE ;

FRASSONI, F ;

GAHRTON, G ;

GOLDMAN, J ;

IRIONDO, A ;

JACOBSEN, N ;

KOLB, HJ ;

LINK, H ;

MICHALLET, M ;

PRENTICE, HG ;

REIFFERS, J ;

VONRHEE, F ;

RUUTU, T ;

SCHWAIGHOFER, H ;

VERNANT, JP ;

DEWITTE, T ;

NIEDERWIESER, D .

BLOOD, 1995, 86 (02) :813-818

[9]

Grebe S C, 1976, Adv Immunol, V22, P119, DOI 10.1016/S0065-2776(08)60549-0

[10] Factors affecting the outcome of allogeneic bone marrow transplantation for adult patients with refractory or relapsed acute leukaemia [J].

Grigg, AP ;

Szer, J ;

Beresford, J ;

Dodds, A ;

Bradstock, K ;

Durrant, S ;

Schwarer, AP ;

Hughes, T ;

Herrmann, R ;

Gibson, J ;

Arthur, C ;

Matthews, J .

BRITISH JOURNAL OF HAEMATOLOGY, 1999, 107 (02) :409-418

← 1 2 3 →