Second allogeneic marrow transplantation for patients with recurrent leukemia after initial transplant with total-body irradiation-containing regimens.
Outcome for infants is comparable to that observed for older children with EMD, for whom a DFS of less than 15% after either conventional chemotherapy or BMT has been reported.33 EMD should be considered as a prognostic factor in addition to phase of disease at transplant, even though our small number of patients precludes definitive determination of whether these variables act independently to influence outcome.
Methotrexate and cyclosporine versus cyclosporine alone for prophylaxis of graft-versus-host disease in patients given HLA-identical marrow grafts for leukemia: Long-term follow-up of a controlled trial. | For patients with acquired severe aplastic anemia without a matched sibling donor and not responding to immunosuppressive treatment, bone marrow transplantation from a suitable alternative donor is often attempted. Javascript disabled. We demonstrate long-term DFS for 5 of 6 patients, with minimal regimen-related toxicity or long-term sequelae observed in the current study. Autologous bone marrow transplantation with 4-hydroperoxycyclophosphamide purged marrows for children with acute non-lymphoblastic leukemia. Thyroid hormone production was evaluated annually in 13 patients and 2 patients have developed thyroid hormone deficiency at 10 and 13 years after transplant. Rev Invest Clin.
Reducing the strength of GVHD prophylaxis also may enhance GVL, an approach that appears to benefit patients in first relapse being grafted from HLA-identical siblings.44,49Thus, we consider MTX alone to be sufficient GVHD prophylaxis for infants, particularly for those with genotypically identical donors.
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Furthermore, we are currently exploring strategies for induction of GVL in infants who do not develop GVHD. However, my husband did want to know. 2019 Sep 2;12(1):87. doi: 10.1186/s13045-019-0775-9. Among the AML patients, 13 were in first remission, 9 were in untreated first relapse or second remission, and 12 were in refractory relapse. Xu LP, Xu ZL, Wang FR, Mo XD, Han TT, Han W, Chen YH, Zhang YY, Wang JZ, Wang Y, Yan CH, Sun YQ, Tang FF, Zhang XH, Huang XJ. Likelihood ratio test for entering presence of EMD into this model yields P = .14. Patient characteristics at diagnosis are shown in Table 1.
Information regarding hormonal status was available for 14 long-term survivors (Table 5). EMD was the only other factor statistically significantly associated with poor outcome in our series. Address reprint requests to Ann E. Woolfrey, MD, Pediatric Transplantation, Fred Hutchinson Cancer Research Center, M185, 1100 Fairview Ave N, Seattle, WA 98109; e-mail: awoolfre@fhcrc.org. Five of these patients were treated with recombinant growth hormone that resulted in improved height SD scores for 3 patients who received therapy before onset of puberty. All 6 MDS patients and 11 of 34 AML patients survive more than 1.5 years later. Bone marrow transplant actually has different types which include the following: Autologous. A second patient developed congestive heart failure (stable with digoxin therapy) and hepatitis C virus hepatitis at 7 and 8 years after BMT, respectively. Remission status was determined within 2 weeks before BMT by histopathologic analysis of bone marrow and cerebral spinal fluid (CSF) and cytogenetic analysis. | Cytomegalovirus pp65 antigenemia-guided early treatment with ganciclovir versus ganciclovir at engraftment after allogeneic marrow transplantation: A randomized double-blind study. 2014 Dec;28(6):1145-55. doi: 10.1016/j.hoc.2014.08.004. Results in the current study are comparable to larger series of older children transplanted in second remission, in which DFS of 37% DFS and relapse risk of 48% have been reported.37 Other studies have reported DFS of 61% to 75% for second remission patients treated with allogeneic3 or autologous BMT38 using preparative regimens similar to those in the current study.
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