期刊
BLOOD
卷 114, 期 13, 页码 2606-2616出版社
AMER SOC HEMATOLOGY
DOI: 10.1182/blood-2009-03-208355
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资金
- National Marrow Donor Program and the Health Resources and Services Administration [240-97-0036, 231-02-0007]
- National Cancer Institute [U24-CA76518]
- National Institute of Allergy and Infectious Diseases
- National Heart, Lung and Blood Institute
- Office of Naval Research
- Health Services Research Administration (DHHS)
- Abbott Laboratories
- Aetna
- American International Group Inc
- American Red Cross
- Amgen Inc
- AnorMED Inc
- Astellas Pharma US Inc
- Baxter International Inc
- Berlex Laboratories Inc
- Biogen IDEC Inc
- BloodCenter of Wisconsin
- Blue Cross and Blue Shield Association
- Bristol-Myers Squibb Company
- BRT Laboratories Inc
- Cangene Corporation
- Celgene Corporation
- CellGenix Inc
- Cell Therapeutics Inc
- CelMed Biosciences
- Cylex Inc
- Cytonome Inc
- CytoTherm
- DOR BioPharma Inc
- Dynal Biotech, an Invitrogen Company
- Enzon Pharmaceuticals Inc
- Gambro BCT Inc
- Gamida Cell Ltd
- Genzyme Corporation
- Gift of Life Bone Marrow Foundation
- GlaxoSmithKline Inc
- Histogenetics Inc
- HKS Medical Information Systems
- Kirin Brewery Co Ltd
- Merck Company
- The Medical College of Wisconsin
- Millennium Pharmaceuticals Inc
- Miller Pharmacal Group
- Milliman USA Inc
- Miltenyi Biotec Inc
- MultiPlan Inc
- National Marrow Donor Program
- Nature Publishing Group
- Novartis Pharmaceuticals Inc
- Osiris Therapeutics Inc
- Pall Medical
- Pfizer Inc
- Pharmion Corporation
- PDL BioPharma, Inc
- Roche Laboratories
- Sanofi-aventis
- Schering Plough Corporation
- StemCyte Inc
- StemSoft Software Inc
- SuperGen, Inc
- Sysmex
- The Marrow Foundation
- THERAKOS Inc
- University of Colorado Cord Blood Bank
- ViaCell Inc
- University of Colorado Cord Blood Bank
- ViaCell Inc
- ViraCor Laboratories
- Wellpoint Inc
- Zelos Therapeutics Inc
- Bundesministerium fur Bildung und Forschung (Kompetenznetz Akute und chronische Leukamien Germany [01GI9981]
We report outcomes of 932 recipients of unrelated donor peripheral blood stem cell hematopoietic cell transplantation (URD-PBSC HCT) for acute myeloid leukemia, acute lymphoblastic leukemia, chronic myelogenous leukemia, and myelodysplastic syndrome enrolled on a prospective National Marrow Donor Program trial from 1999 through 2003. Preparative regimens included myeloablative (MA; N = 611), reduced-intensity (RI; N = 160), and nonmyeloablative (NMA; N = 161). For MA recipients, CD34(+) counts greater than 3.8 X 10(6)/kg improved neutrophil and platelet engraftment, whereas improved overall survival (OS) and reduced transplant-related mortality (TRM) were seen for all preparative regimens when CD34(+) cell doses exceeded 4.5 X 10(6)/kg. Higher infused doses of CD34(+) cell dose did not result in increased rates of either acute or chronic graft-versus-host disease (GVHD). Three-year OS and disease-free survival (DFS) of recipients of MA, RI, and NMA approaches were similar (33%, 35%, and 32% OS; 33%, 30%, and 29% DFS, respectively). In summary, recipients of URD-PBSC HCT receiving preparative regimens differing in intensity experienced similar survival. Higher CD34(+) cell doses resulted in more rapid engraftment, less TRM, and better 3-year OS (39% versus 25%, MA, P = .004; 38% versus 21% RI/NMA, P = .004) but did not increase the risk of GVHD. This trial was registered at www.clinicaltrials.gov as #NCT00785525. (Blood. 2009; 114: 2606-2616)
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