https://scholars.lib.ntu.edu.tw/handle/123456789/562952
標題: | Allogeneic stem cell transplantation for patients with high-risk myelodysplastic syndrome | 作者: | CHIUN HSU Lin M.-T. JIH-LUH TANG HWEI-FANG TIEN Wang C.-H. YAO-CHANG CHEN |
公開日期: | 1999 | 卷: | 98 | 期: | 3 | 起(迄)頁: | 157-164 | 來源出版物: | Journal of the Formosan Medical Association | 摘要: | Allogeneic stem cell transplantation (allo-SCT) is the only treatment with curative potential for patients with myelodysplastic syndrome (MDS). From June 1986 to April 1997, we treated 12 patients with primary MDS (5 men, 7 women, median age, 36.5 years) by allo-SCT. All patients had one or more of the following poor prognostic, factors: intermediate-2 or high-risk categories according to the International Prognostic Scoring System; disease progression during follow-up; heavy transfusion requirements and recurrent infections. The median duration from diagnosis of MDS to allo-SCT was 6 months. The preconditioning regimen included total body irradiation combined with either high-dose cytarabine (n = 6), high-dose cyclophosphamide (n = 4), or other regimens (n = 2). Ten patients received bone marrow transplantations and two patients received peripheral blood stem cell transplantations. Prophylaxis for graft-versus-host disease (GVHD) consisted of standard cyclosporin and short-course methotrexate. Acute GVHD of grade 2 or above occurred in 10 patients while chronic GVHD occurred in seven of the nine patients who survived longer than 6 months after allo-SCT. With a median follow- up of 50 months, all nine patients with human leukocyte antigen (HLA)-matched sibling donors survived. One patient had a relapse 6 months after transplantation and achieved complete remission again with low-dose cytarabine therapy. The three patients receiving allo-SCT from unrelated or HLA-mismatched donors died of grade 3 to 4 acute GVHD and infection within 5 months after transplantation. The estimated disease-free survival at 4 years was 67% (95% confidence interval, 40-93%), and the overall survival was 75% (95% confidence interval, 50-99%). Our data suggest that allo-SCT should be considered early in the clinical course for young MDS patients with a poor prognosis and a matched sibling donor. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/562952 | ISSN: | 0929-6646 | SDG/關鍵字: | cyclophosphamide; cytarabine; methotrexate; adult; allogeneic restriction; allogenic bone marrow transplantation; article; blood transfusion; clinical article; clinical feature; disease course; female; graft versus host reaction; HLA matching; human; human cell; male; myelodysplastic syndrome; prognosis; recurrent infection; remission; scoring system; stem cell transplantation; whole body radiation; Adult; Disease-Free Survival; Female; Hematopoietic Stem Cell Transplantation; Humans; Male; Middle Aged; Myelodysplastic Syndromes; Survival Rate; Taiwan; Transplantation Conditioning |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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