By Mary J. Laughlin, Hillard M. Lazarus
The world over well-known physicians and researchers evaluate either the fundamentals of allogeneic stem mobilephone transplantation and up to date advances within the box, quite as they relate to antitumor results and graft-versus-host sickness additionally they offer specified decision-tree analyses to steer clinicians in identifying and handling their allogeneic transplant sufferers. The concepts mentioned hide numerous parts, starting from stem phone mobilization in basic donors, to symptoms for allogeneic transplantation except hematologic malignancies, to using nonmyeloablative conditioning regimens. The authors additionally discover new advancements within the optimum choice of unrelated allogeneic grafts (e.g., matched unrelated donor, partly mismatched loved one, or umbilical wire blood), the use allogeneic peripheral blood stem mobile vs marrow-derived grafts for transplantation, and the kinetics of immune reconstitution after transplantation.
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Extra info for Allogeneic Stem Cell Transplantation (Current Clinical Oncology)
A number of large prospective studies in pediatric ALL have demonstrated the independent prognostic significance of MRD detection. Using semiquantitative PCR for the detection of the leukemia “clonespecific” immunoglobulin heavy chain or T cell receptor gene rearrangement, these studies have shown that persistent MRD detection at various time points following achievement of morphologic and cytogenetic remission is a highly significant and independent prognosticator of relapse (12,13). Less is known about the significance of MRD detection in adult ALL.
Bone marrow transplantation for acute nonlymphoblastic leukemia in first remission: Analysis of prognostic factors. Blood 1985;65:1191–1196. 39. Clift RA, Buckner CD, Thomas ED, et al. The treatment of acute nonlymphoblastic leukemia by allogeneic transplantation. Bone Marrow Transplant 1987;2:243–258. 40. Forman SJ, Spruce WE, Farbstein MJ, et al. Bone marrow ablation followed by allogeneic marrow grafting during first complete remission of acute nonlymphocytic leukemia. Blood 1983;61:439–442.
Analyzed International Bone Marrow Transplant Registry (IBMTR) data for 484 patients who had received intensive postremission chemotherapy, and 251 recipients of HLA-identical allogeneic SCT for ALL in CR1. Patients ranged from 15 to 45 yr of age and were treated between 1980 and 1987. Similar prognostic factors, including non-T lineage phenotype, high leukocyte count at presentation, and greater than 8 wk to achieve CR, predicted treatment failure in both treatment groups. After statistical adjustments were made for differences in disease characteristics, 5-yr leukemia-free survival (LFS) was similar in the chemotherapy (38%) and allogeneic SCT (44%) cohorts; 32 Part II / Disease Indications: Allogeneic Transplantation Table 1 Comparative Trials of Transplantation vs Chemotherapy for ALL in CR1 Study No.