Clift R A, Buckner C D, Thomas E D, Bryant E, Anasetti C, Bensinger W I, Bowden R, Deeg H J, Doney K C, Fisher L D
Fred Hutchinson Cancer Research Center, Seattle, WA.
Blood. 1994 Dec 15;84(12):4368-73.
The records were reviewed of 58 patients receiving transplants in Seattle with unmanipulated marrow from HLA-identical siblings during the accelerated phase (AP) of chronic myeloid leukemia. Variables examined for association with survival and relapse included the interval from diagnosis to transplant, the reasons for categorization as AP, age, regimen, and cytomegalovirus serology. Four patients relapsed. The 4-year probabilities of survival, relapse-free survival, nonrelapse mortality, and relapse were 0.49, 0.43, 0.51, and 0.12, respectively. After completion of the stepwise multivariate analysis, age less than 38 years and categorization as AP solely on the basis of chromosomal abnormalities emerged as being independently significantly associated with improved survival. The 4-year probability of survival for the 16 patients categorized as AP because of chromosomal abnormalities and receiving transplant less than 1 year from diagnosis was 0.74. The low probability of relapse in these patients suggests that more aggressive preparative regimens are not indicated for patients receiving transplants in AP because of the increased risk of transplant-related mortality.
对58例在慢性髓性白血病加速期（AP）接受来自HLA匹配同胞的未处理骨髓移植的西雅图患者的记录进行了回顾。检查与生存和复发相关的变量包括从诊断到移植的间隔、归类为AP的原因、年龄、治疗方案和巨细胞病毒血清学。4例患者复发。4年生存率、无复发生存率、非复发死亡率和复发率分别为0.49、0.43、0.51和0.12。在逐步多变量分析完成后，年龄小于38岁以及仅基于染色体异常归类为AP被发现与生存率提高独立显著相关。16例因染色体异常归类为AP且在诊断后不到1年接受移植的患者的4年生存率为0.74。这些患者的低复发率表明，对于因移植相关死亡率增加而在AP期接受移植的患者，不建议采用更积极的预处理方案。
