Blood, 1 October 2007, Vol. 110, No. 7, pp. 2744-2748.
Prepublished online as a Blood First Edition Paper on June 26, 2007; DOI 10.1182/blood-2007-03-078592.
 Previous Article | Next Article 
Submitted March 16, 2007
Accepted June 4, 2007
Relapse risk in patients with malignant diseases given allogeneic hematopoietic cell transplantation after nonmyeloablative conditioning
Christoph Kahl, Barry E Storer, Brenda M. Sandmaier, Marco Mielcarek, Michael B Maris, Karl G Blume, Dietger Niederwieser, Thomas R Chauncey, Stephen J Forman, Edward Agura, Jose F Leis, Benedetto Bruno, Amelia Langston, Michael A Pulsipher, Peter A McSweeney, James C Wade, Elliot Epner, Finn Bo Petersen, Wolfgang A Bethge, David G Maloney, and Rainer Storb*
Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States
University of Washington School of Medicine, Seattle, WA, United States
BMT, Rocky Mountain Blood and Marrow Transplant Program, Denver, CO, United States
BMT, Stanford University, Stanford, CA, United States
Department of Medicine, University of Leipzig, Leipzig, Germany
Veterans Affairs Puget Sound Health System, Seattle, WA, United States
BMT, City of Hope National Medical Center, Duarte, CA, United States
BMT, Baylor University, Dallas, TX, United States
BMT, Oregon Health and Science University, Portland, OR, United States
BMT, University of Torino, Torino, Italy
BMT, Emory University, Atlanta, GA, United States
BMT, University of Utah Health Sciences Center, Salt Lake City, UT, United States
BMT, Medical College of Wisconsin, Milwaukee, WI, United States
Blood and Marrow Outpatient Clinic, Intermountain Healthcare - LDS Hospital, Salt Lake City, UT, United States
BMT, University Hospital Tuebingen, Tuebingen, Germany
* Corresponding author; email: rstorb{at}fhcrc.org.
Allogeneic hematopoietic cell transplantation (HCT) after nonmyeloablative conditioning for hematologic malignancies depends on graft-versus-tumor effects for eradication of cancer. Here, we estimated relapse risks according to disease characteristics. Between 1997 and 2006, 834 consecutive patients (median age, 55; range, 5-74 years) received related (n=498) or unrelated (n=336) HCT after 2 Gy total body irradiation alone (n=171), or combined with fludarabine (90 mg/m2; n=663). Relapse rates per patient year (PY) at risk, corrected for follow-up and competing non-relapse mortality, were calculated for 29 different diseases and stages. The overall relapse rate per PY was 0.36. Patients with CLL and MM in remission (CR), low-grade or mantle cell NHL (CR + PR), and high-grade NHL-CR had the lowest rates (0.00-0.24; low risk). In contrast, patients with advanced myeloid and lymphoid malignancies had rates of >0.52 (high risk). Patients with lymphoproliferative diseases not in CR (except Hodgkin lymphoma and high grade NHL) and myeloid malignancies in CR had rates of 0.26-0.37 (standard risk). In conclusion, patients with low-grade lymphoproliferative disorders experienced the lowest relapse rates, whereas patients with advanced myeloid and lymphoid malignancies had high relapse rates after nonmyeloablative HCT. The latter might benefit from cytoreductive treatment before HCT.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati What's this?
This article has been cited by other articles:
|
|
|
|
 
M. Yanada, G. Garcia-Manero, G. Borthakur, F. Ravandi, H. Kantarjian, and E. Estey
Relapse and death during first remission in acute myeloid leukemia
Haematologica,
April 1, 2008;
93(4):
633 - 634.
[Full Text]
[PDF]
|
|
|
|
|
