期刊
BONE MARROW TRANSPLANTATION
卷 36, 期 9, 页码 781-785出版社
NATURE PUBLISHING GROUP
DOI: 10.1038/sj.bmt.1705135
关键词
chronic GvHD; children; allogeneic PBSC transplantation
We analyzed the clinical outcome in 90 children undergoing allogeneic PBSC transplantation from HLA-identical relative for leukemia. GvHD prophylaxis was CsA_ methotrexate in 50 and CsA +/- steroids in 40. Median CD34+ cells infused were 6 x 10(6)/kg (range, 1.4-32). Median follow-up was 60 months ( range, 6-115). CI of transplant-related mortality (TRM) was 18.4 +/- 4%. On multivariate analysis, high Lansky score ( 480) at transplantation was associated with lower TRM (HR, 0.9; P<0.0002). Relapse incidence ( RI) was 33.6 +/- 6%. On multivariate analysis, high Lansky score at transplantation and cGvHD were associated with lower RI (HR, 0.04; P < 0.0005 and HR, 0.23; P < 0.03, respectively). Disease-free survival (DFS) was 57.8 +/- 5%. Disease status at transplantation ( HR, 0.33; P < 0.02), steroid treatment at day + 90 (HR, 5.61; P < 0.005) and cGvHD (HR, 0.23; P < 0.005) had a significant impact on DFS in multivariate analysis. CI of cGvHD was 63.7 +/- 7%. Patients with cGvHD had better DFS (65 +/- 5%) because of lower RI (15.7 +/- 6%) and similar TRM (27.4 +/- 4%). These data suggest acceptable long-term outcomes after allogeneic PBSC transplantation in children despite the high incidence of cGvHD. These patients had a lower risk of relapse and a better DFS.
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