Outcome of 93 patients with relapse or progression following allogeneic hematopoietic cell transplantation

Saiko Kurosawa, Takahiro Fukuda, Kinuko Tajima, Bungo Saito, Shigeo Fuji, Hiroki Yokoyama, Sung W. Kim, Shin Ichiro Mori, Ryuji Tanosaki, Yuji Heike, Yoichi Takaue

研究成果: Article

15 引用 (Scopus)

抄録

Relapse/progression after allogeneic hematopoietic cell transplantation (allo-HCT) remains the major cause of treatment failure. In this study, the subsequent clinical outcome was overviewed in 292 patients with leukemia/ myelodysplastic syndrome who received allo-HCT. Among them, 93 (32%) showed relapse/progression. Cohort 1 was chosen to receive no interventions with curative intent (n 5 25). Cohort 2 received reinduction chemotherapy and/or donor lymphocyte infusion (n 5 48), and Cohort 3 underwent a second allo-HCT (n 5 20). Sixty-three patients received reinduction chemotherapy, and 27 (43%) achieved subsequent complete remission (CR). The incidence of nonrelapse mortality (NRM) was similar among the three cohorts (4, 15, and 5%). The 1-year overall survival (OS) after relapse was significantly better in patients with a second HCT (58%) than in others (14%, Cohorts 1 and 2; P < .001). However, the 2-year OS did not differ between the two groups, which suggests that it is difficult to maintain CR after the second HCT. Multivariate analysis showed that reinduction chemotherapy, CR after intervention, second HCT, and longer time to post-transplant relapse were associated with improved survival. In conclusion, for patients with relapse after allo-HCT, successful reinduction chemotherapy and a second HCT may be effective for prolonging survival without excessive NRM. However, effective measures to prevent disease progression after a second HCT clearly need to be developed.

元の言語English
ページ(範囲)815-820
ページ数6
ジャーナルAmerican Journal of Hematology
84
発行部数12
DOI
出版物ステータスPublished - 2009 12
外部発表Yes

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Cell Transplantation
Recurrence
Drug Therapy
Survival
Mortality
Myelodysplastic Syndromes
Treatment Failure
Disease Progression
Leukemia
Multivariate Analysis
Tissue Donors
Lymphocytes
Transplants
Incidence

ASJC Scopus subject areas

  • Hematology

これを引用

Kurosawa, S., Fukuda, T., Tajima, K., Saito, B., Fuji, S., Yokoyama, H., ... Takaue, Y. (2009). Outcome of 93 patients with relapse or progression following allogeneic hematopoietic cell transplantation. American Journal of Hematology, 84(12), 815-820. https://doi.org/10.1002/ajh.21555

Outcome of 93 patients with relapse or progression following allogeneic hematopoietic cell transplantation. / Kurosawa, Saiko; Fukuda, Takahiro; Tajima, Kinuko; Saito, Bungo; Fuji, Shigeo; Yokoyama, Hiroki; Kim, Sung W.; Mori, Shin Ichiro; Tanosaki, Ryuji; Heike, Yuji; Takaue, Yoichi.

:: American Journal of Hematology, 巻 84, 番号 12, 12.2009, p. 815-820.

研究成果: Article

Kurosawa, S, Fukuda, T, Tajima, K, Saito, B, Fuji, S, Yokoyama, H, Kim, SW, Mori, SI, Tanosaki, R, Heike, Y & Takaue, Y 2009, 'Outcome of 93 patients with relapse or progression following allogeneic hematopoietic cell transplantation', American Journal of Hematology, 巻. 84, 番号 12, pp. 815-820. https://doi.org/10.1002/ajh.21555
Kurosawa, Saiko ; Fukuda, Takahiro ; Tajima, Kinuko ; Saito, Bungo ; Fuji, Shigeo ; Yokoyama, Hiroki ; Kim, Sung W. ; Mori, Shin Ichiro ; Tanosaki, Ryuji ; Heike, Yuji ; Takaue, Yoichi. / Outcome of 93 patients with relapse or progression following allogeneic hematopoietic cell transplantation. :: American Journal of Hematology. 2009 ; 巻 84, 番号 12. pp. 815-820.
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abstract = "Relapse/progression after allogeneic hematopoietic cell transplantation (allo-HCT) remains the major cause of treatment failure. In this study, the subsequent clinical outcome was overviewed in 292 patients with leukemia/ myelodysplastic syndrome who received allo-HCT. Among them, 93 (32{\%}) showed relapse/progression. Cohort 1 was chosen to receive no interventions with curative intent (n 5 25). Cohort 2 received reinduction chemotherapy and/or donor lymphocyte infusion (n 5 48), and Cohort 3 underwent a second allo-HCT (n 5 20). Sixty-three patients received reinduction chemotherapy, and 27 (43{\%}) achieved subsequent complete remission (CR). The incidence of nonrelapse mortality (NRM) was similar among the three cohorts (4, 15, and 5{\%}). The 1-year overall survival (OS) after relapse was significantly better in patients with a second HCT (58{\%}) than in others (14{\%}, Cohorts 1 and 2; P < .001). However, the 2-year OS did not differ between the two groups, which suggests that it is difficult to maintain CR after the second HCT. Multivariate analysis showed that reinduction chemotherapy, CR after intervention, second HCT, and longer time to post-transplant relapse were associated with improved survival. In conclusion, for patients with relapse after allo-HCT, successful reinduction chemotherapy and a second HCT may be effective for prolonging survival without excessive NRM. However, effective measures to prevent disease progression after a second HCT clearly need to be developed.",
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