JOHN M. GOLDMAN, M.D.; ROBERT PETER GALE, M.D., Ph.D.; MARY M. HOROWITZ, M.D.; JAMES C. BIGGS, M.D., Ph.D.; RICHARD E. CHAMPLIN, M.D.; ELIANE GLUCKMAN, M.D.; RAYMOND G. HOFFMANN, Ph.D.; STEVEN J. JACOBSEN; ALBERTO M. MARMONT, M.D.; PHILIP B. McGLAVE, M.D.; HANS A. MESSNER, M.D., Ph.D.; ALFRED A. RIMM, Ph.D.; CIRIL ROZMAN, M.D.; BRUNO SPECK, M.D.; SANTE TURA, M.D.; ROY S. WEINER, M.D.; MORTIMER M. BORTIN, M.D.
GOLDMAN JM, GALE RP, HOROWITZ MM, BIGGS JC, CHAMPLIN RE, GLUCKMAN E, et al. Bone Marrow Transplantation for Chronic Myelogenous Leukemia in Chronic Phase: Increased Risk for Relapse Associated with T-Cell Depletion. Ann Intern Med. 1988;108:806-814. doi: 10.7326/0003-4819-108-6-806
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Published: Ann Intern Med. 1988;108(6):806-814.
Data on 405 patients with chronic myelogenous leukemia who received bone marrow transplants in chronic phase were analyzed for factors predictive of outcome. The 4-year actuarial probability of relapse was 19% (95% confidence interval [Cl], 12% to 28% ) and of survival, 55% (95% Cl, 50% to 60%). In multivariate analyses the probability of relapse was higher for recipients of T-cell-depleted bone marrow compared with recipients of non-T-cell-depleted bone marrow (relative risk, 5.4; P < 0.0001) and for patients who did not develop chronic graft-versus-host disease with patients who did (relative risk, 3.1; P < 0.01). The probability of survival was lower for patients who developed moderate to severe acute graft-versus-host disease than for patients with no or mild acute graft-versus-host disease (relative risk, 3.7; P < 0.0001), and in patients aged 20 or older than in younger patients (relative risk, 2.6; P < 0.0002). Duration of disease before transplant was not associated with outcome. Bone marrow transplantation done in the chronic phase of chronic myelogenous leukemia offers some patients prolonged leukemia-free survival. The Tcell-depleted grafts are associated with an increased probability of relapse.
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