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Allogeneic marrow transplantation for chronic granulocytic leukemia
Journal of the National Cancer Institute
|June 1, 1986
Summary
Allogeneic bone marrow transplantation (BMT) offers a chance for cure in chronic granulocytic leukemia. Early BMT in chronic phase (CP) yields better survival rates than in advanced phases.
Area of Science:
- Hematology
- Oncology
- Transplantation Medicine
Background:
- Philadelphia chromosome-positive chronic granulocytic leukemia (CGL) is a myeloproliferative neoplasm.
- Conventional therapies for advanced CGL have limited efficacy.
- Allogeneic bone marrow transplantation (BMT) is a potential curative option.
Purpose of the Study:
- To evaluate the outcomes of allogeneic BMT in patients with CGL across different disease phases.
- To determine the impact of disease phase on survival and relapse rates post-BMT.
- To provide recommendations for BMT timing in CGL management.
Main Methods:
- Retrospective analysis of 23 blastic phase (BP), 33 accelerated phase (AP), and 45 chronic phase (CP) CGL patients.
- All patients underwent allogeneic BMT.
- Follow-up ranged from 1-8 years post-transplantation.
Main Results:
- Long-term survival probabilities were 14% (BP), 10% (AP), and 58% (CP).
- 3-year relapse probabilities were 80% (BP), 38% (AP), and 31% (CP).
- Splenectomy did not affect post-transplant survival.
Conclusions:
- BMT offers a possibility of cure for CGL, particularly in the chronic phase.
- Patients younger than 50 in BP or AP should be considered for BMT due to poor prognosis.
- Early BMT in CP (before progression to AP) is recommended for patients under 40, with full understanding of risks and benefits.