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Second early allogeneic stem cell transplantations for graft failure in acute leukaemia, chronic myeloid leukaemia and aplastic anaemia. French Society of Bone Marrow Transplantation
- Source :
- British journal of haematology. 111(1)
- Publication Year :
- 2000
-
Abstract
- In this retrospective multicentre study, we analysed the results of 82 consecutive second early allogeneic transplants for primary (n = 28) or secondary ([n = 54) graft failures performed between 1985 and 1997 in patients with acute leukaemia (n = 33), aplastic anaemia (n = 29) or chronic myeloid leukaemia (n = 20). HLA-matched siblings were used in 64 cases. The same donors were used for both transplants in 56 cases and the first transplant was T-cell depleted in 30 cases. The median age at transplant was 25 years and the median intertransplant time interval was 2 months. Estimates of the 3-year overall survival and day 100 transplant-related mortality were 30% and 53% respectively. A recipient age34 years at transplant, an intertransplant time intervalor = 80 d and a positive recipient cytomegalovirus serology were predictors of a better outcome. The use of cyclosporin A (CsA) after second transplant had a dramatic impact on outcome, the best results being observed with CsA alone. The day 40 probability of neutrophil recovery was 73%. The use of peripheral blood progenitor cells (PBPCs) was associated with a higher and faster neutrophil recovery. Other factors associated with neutrophil recovery were an intertransplant time intervalor = 80 d and a positive recipient cytomegalovirus serology. Therefore, second early allogeneic transplantation for graft failure is an effective treatment, especially if patients can receive CsA for graft-versus-host disease prevention and are retransplanted more than 80 d from first transplant.
- Subjects :
- Adult
Graft Rejection
Male
Reoperation
Chi-Square Distribution
Leukemia
Adolescent
Hematopoietic Stem Cell Transplantation
Anemia, Aplastic
Graft vs Host Disease
Infant
Middle Aged
Statistics, Nonparametric
Treatment Outcome
Child, Preschool
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Cyclosporine
Humans
Transplantation, Homologous
Female
Child
Immunosuppressive Agents
Follow-Up Studies
Proportional Hazards Models
Retrospective Studies
Subjects
Details
- ISSN :
- 00071048
- Volume :
- 111
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- British journal of haematology
- Accession number :
- edsair.pmid..........d24667e6829b18959d871d68644d6fb3