Journal
BLOOD
Volume 110, Issue 7, Pages 2744-2748Publisher
AMER SOC HEMATOLOGY
DOI: 10.1182/blood-2007-03-078592
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Funding
- NCI NIH HHS [P01 CA078902, CA49605, P01 CA049605, CA30206, CA18029, CA78902, P30 CA015704, CA15704, P01 CA030206, P01 CA018029] Funding Source: Medline
- NHLBI NIH HHS [P01 HL036444, HL36444] Funding Source: Medline
- NIDDK NIH HHS [DK064715, K08 DK064715] Funding Source: Medline
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Allogeneic hematopoietic cell transplantation (HCT) after nonmyeloablative conditioning for hematologic malignancies depends on graft-versus-tumor effects for eradication of cancer. Here, we estimated relapse risks according to disease characteristics. Between 1997 and 2006,834 consecutive patients (median age, 55 years; range, 5-74 years) received related (n = 498) or unrelated (n = 336) HCT after 2 Gy total body irradiation alone (n = 171) or combined with fludarabine (go mg/m(2); n = 663). Relapse rates per patient year (PY) at risk, corrected for follow-up and competing nonrelapse mortality, were calculated for 29 different diseases and stages. The overall relapse rate per PY was 0.36. Patients with chronic lymphocytic leukemia (CLL) and multiple myeloma (MM) in remission (CR), low-grade or mantle cell non-Hodgkin lymphoma (NHL) (CR + partial remission [PR]), and high-grade NHL-CR had the lowest rates (0.00-0.24; low risk). In contrast, patients with advanced myeloid and lymphoid malignancies had rates of more than 0.52 (high risk). Patients with lymphoproliferative diseases not in CR (except Hodgkin lymphoma and high-grade NHL) and myeloid malignancies in CR had rates of 0.26-0.37 (standard risk). In conclusion, patients with low-grade lymphoproliferative disorders experienced the lowest relapse rates, whereas patients with advanced myeloid and lymphoid malignancies had high relapse rates after nonmyeloalbative HCT. The latter might benefit from cytoreductive treatment before HCT.
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