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Your search keyword '"Transplantrelated mortality"' showing total 2 results
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2 results on '"Transplantrelated mortality"'

1. Early related or unrelated haematopoietic cell transplantation results in higher overall survival and leukaemia-free survival compared with conventional chemotherapy in high-risk acute myeloid leukaemia patients in first complete remission.

Author

Basara, N., Schulze, A., Wedding, U., Mohren, M., Gerhardt, A., Junghanss, C., Peter, N., Dölken, G., Becker, C., Heyn, S., Kliem, C., Lange, T., Krahl, R., Pönisch, W., Fricke, H.-J., Sayer, H. G., Al-Ali, H., Kamprad, F., and Niederwieser, D.

Subjects
*MYELOID leukemia, *CELL transplantation, *BONE marrow diseases, *CANCER chemotherapy, *LEUKEMIA, *HEMATOPOIESIS, *PATIENTS
Abstract

Between 1996 and 2004, a total of 708 patients were enrolled in the acute myeloid leukaemia (AML) ‘96 and ‘02 studies of the East German Study Group (OSHO). Of these, 138 patients (19.5%) had unfavourable cytogenetics defined as complex karyotype, del (5q)/-5, del (7q)/-7, abn (3q26) and abn (11q23). In all, 77 (56%) achieved complete remission 1 (CR1) after induction chemotherapy and were eligible for haematopoietic cell transplantation (HCT). HCT was performed after a median of two cycles of consolidation chemotherapy (CT) in the AML ‘96 and one cycle in the AML ‘02 study (P=0.03). After a median follow-up of 19 months, overall survival (OS) at two years was significantly better in the donor group (52±9%) versus the no-donor group (24±8%; P=0.005). Differences in outcomes were mainly because of a lower relapse incidence in patients after HCT (39±11%) compared with a higher relapse incidence in patients undergoing CT (77±10%; P=0.0005). Treatment-related mortality was low and not statistically significantly different between the two treatment groups (15±7 and 5±5% for HCT and chemotherapy, respectively; P=0.49).We conclude that early HCT from related or unrelated donors led to significantly better OS and leukaemia-free survival compared with chemotherapy in patients with unfavourable karyotype.Leukemia (2009) 23, 635–640; doi:10.1038/leu.2008.352; published online 8 January 2009 [ABSTRACT FROM AUTHOR]

Published
2009
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2. Extracorporeal photopheresis for steroid resistant graft versus host disease in pediatric patients: A pilot single institution report

Author

Massimo, Berger, Berger, Massimo, Rosanna, Pessolano, Pessolano, Rosanna, Roberto, Albiani, Albiani, Roberto, Sebastian, Asaftei, Asaftei, Sebastian, Veronica, Barat, Barat, Veronica, Francesca, Carraro, Carraro, Francesca, Eleonara, Biasin, Biasin, Eleonora, Enrico, Madon, Madon, Enrico, Franca, Fagioli, and Fagioli, Franca

Subjects
Male, medicine.medical_treatment, Extracorporeal photopheresis, Drug Resistance, Graft vs Host Disease, Pilot Projects, Gastroenterology, Pediatrics, Photopheresis, immune system diseases, hemic and lymphatic diseases, Extracorporeal Photopheresis, Child, Bone Marrow Transplantation, GvHD, Leukemia, Transplantrelated mortality, Hematopoietic Stem Cell Transplantation, Hematology, Perinatology and Child Health, surgical procedures, operative, Treatment Outcome, Oncology, Female, Steroids, Homologous, medicine.medical_specialty, Adolescent, Internal medicine, medicine, Transplantation, Homologous, Humans, Retrospective Studies, Transplantation, business.industry, Retrospective cohort study, medicine.disease, Confidence interval, Surgery, Clinical trial, Chronic Disease, Drug Resistance, Neoplasm, Pediatrics, Perinatology and Child Health, Graft-versus-host disease, Relative risk, Neoplasm, business
Abstract

This study was aimed at ascertaining whether extracorporeal photopheresis (ECP) is an effective treatment for pediatric patients with steroid resistant graft versus host disease (GvHD). Fifteen patients with acute GvHD (aGvHD) and 10 patients with chronic GvHD (cGvHD) were enrolled in the study. At the start of the ECP protocol, aGvHD was staged as II (n=7), III (n=4), and IV (n=4). The response rate was 100% for aGvHD II, 75% for aGvHD III, and finally 0% for aGvHD IV (P=0.02). In multivariate analysis, the strongest predictor for ECP response was the aGvHD severity: aGvHD II 100%, aGvHD III-IV 30% [relative risk (RR) 5.071, confidence interval (CI) 95% 2.2-5.5, P=0.0016], this translates in a higher risk of transplant-related mortality for ECP nonresponders (RR 5.26, CI 95% 3.4-6.2, P=0.02). cGvHD was diagnosed as limited n=3, and extensive n=7; the response rate was 100% and 28% for limited or extensive cGvHD, respectively (P=0.03). For cGvHD the strongest predictor for ECP response was the absence of visceral organ involvement (RR 5.17, CI 95% 2-4.9, P=0.001), and the highest risk of transplant-related mortality was among patients not responding to ECP (RR 12.4, CI 95%, P=0.02). Our results suggest that ECP can rescue good-risk GvHD-patients, whereas for advanced, poor-risk GvHD patients, new therapies are required.

Published
2007

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