The significance of graft-versus-host disease and pretransplantation minimal residual disease status to outcome after allogeneic stem cell transplantation in patients with acute lymphoblastic leukemia

被引:65
作者
Uzunel, M [1 ]
Mattsson, J
Jaksch, M
Remberger, M
Ringdén, O
机构
[1] Huddinge Univ Hosp, Karolinska Inst, Dept Clin Immunol, SE-14186 Stockholm, Sweden
[2] Huddinge Univ Hosp, Karolinska Inst, Ctr Allogen Stem Cell Transplantat, SE-14186 Stockholm, Sweden
关键词
D O I
10.1182/blood.V98.6.1982
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Relapse is the major cause of treatment failure after allogeneic stem cell transplantation (SCT) in patients with acute lymphoblastic leukemia. Minimal residual disease (MRD) was analyzed before SCT in 30 patients with acute lymphoblastic leukemia. The aim was to determine whether the level of MRD before transplantation was correlated with outcome. Fifteen patients were found to have high-level MRD (10(-2) to 10(-3)), 10 had low-level MRD (< 10(-3)), and 5 were MRD-. Among MRD- patients the probability of relapse was 0 in 5, which was less than in MRD+ patients (13 of 25) (P = .05). No major difference was found between the high- and low-level MRD+ groups. Among the MRD+ patients, only 2 of 11 with acute and chronic graft-versus-host disease had a relapse, versus 11 of 14 without (P = .005). In conclusion, for patients entering transplantation While they have residual disease, a combination of acute and chronic graft-versus-host disease may be needed to decrease the risk of relapse after SCT.
引用
收藏
页码:1982 / 1984
页数:3
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