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Erschienen in: Annals of Hematology 4/2017

16.01.2017 | Original Article

Salvage therapy for acute chemorefractory leukemia by allogeneic stem cell transplantation: the Korean experience

verfasst von: Shin Hye Yoo, Youngil Koh, Dae-Young Kim, Jung-Hee Lee, Je-Hwan Lee, Kyoo-Hyung Lee, Sung-Soo Yoon, Seonyang Park, Sung-Kyu Park, Dae-Sik Hong, Hyeon Gyu Yi, Chul-Soo Kim, Ji Eun Jang, June-Won Cheong, Joonho Moon, Yoo Hong Min, Sang Kyun Sohn, Inho Kim, for the Korean Society of Blood and Marrow Transplantation

Erschienen in: Annals of Hematology | Ausgabe 4/2017

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Abstract

Little is known about the characteristics that make patients with acute leukemia suitable for undergoing salvage therapy by allogeneic hematopoietic stem cell transplantation (allo-HSCT). Here, we analyzed the clinical outcomes of 223 patients with acute leukemia who underwent allo-HSCT while not in complete remission (CR). The primary end points were overall survival (OS) and CR rate. CR was achieved in 79.8% of patients after allo-HSCT. Acute graft-versus-host disease (GVHD) was significantly associated with CR (P = 0.045). During a median follow-up of 30.1 months, the median OS was 6.1 months. OS was significantly longer in patients with good or standard risk cytogenetic characteristics than in those with poor risk cytogenetic characteristics (P = 0.029, P = 0.030, respectively). Patients who received allo-HSCT from a matched sibling donor had better survival than those with unrelated donors (P = 0.015). Primary chemorefractoriness was not associated with poor survival (P = 0.071). The number of chemotherapies before allo-HSCT was significantly correlated with outcome (P = 0.006). Chronic GVHD was a strong predictor of a longer OS (P = 0.025). In conclusion, survival of patients with primary chemorefractory acute leukemia is not lower when treated upfront with allo-HSCT. Hence, allo-HSCT should be actively considered in such patients. Acute and chronic GVHD is associated with better outcomes patients with acute leukemia who have undergone allo-HSCT and not achieved CR.
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Metadaten
Titel
Salvage therapy for acute chemorefractory leukemia by allogeneic stem cell transplantation: the Korean experience
verfasst von
Shin Hye Yoo
Youngil Koh
Dae-Young Kim
Jung-Hee Lee
Je-Hwan Lee
Kyoo-Hyung Lee
Sung-Soo Yoon
Seonyang Park
Sung-Kyu Park
Dae-Sik Hong
Hyeon Gyu Yi
Chul-Soo Kim
Ji Eun Jang
June-Won Cheong
Joonho Moon
Yoo Hong Min
Sang Kyun Sohn
Inho Kim
for the Korean Society of Blood and Marrow Transplantation
Publikationsdatum
16.01.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
Annals of Hematology / Ausgabe 4/2017
Print ISSN: 0939-5555
Elektronische ISSN: 1432-0584
DOI
https://doi.org/10.1007/s00277-017-2919-8

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