PMID- 15060748
OWN - NLM
STAT- MEDLINE
DCOM- 20040525
LR  - 20221207
IS  - 0939-5555 (Print)
IS  - 0939-5555 (Linking)
VI  - 83
IP  - 5
DP  - 2004 May
TI  - Long term follow-up of Asian patients with chronic myeloid leukemia (CML) 
      receiving allogeneic hematopoietic stem cell transplantation (HSCT) from 
      HLA-identical sibling-evaluation of risks and benefits.
PG  - 286-94
AB  - Allogeneic hematopoietic stem cell transplantation (HSCT) is the only known 
      curative therapy for patients with chronic myeloid leukemia (CML), but is 
      associated with significant morbidity and mortality. The recent introduction of 
      imatinib mesylate (STI-571) and reduced intensity transplant regimens has made 
      the choice of primary treatment for patients with CML increasingly difficult. We 
      have evaluated the outcome of 53 patients who have received allogeneic HSCT from 
      human leukocyte antigen (HLA)-identical sibling donors between October 1985 and 
      March 2002, determined the variables affecting the outcome, and tried to define 
      indications for this aggressive approach. Successful engraftment occurred in 49 
      (98%) of evaluable patients. Acute graft-versus-host disease (GVHD) of grade II 
      to IV severity was observed in 63% of the evaluable patients whereas the 
      incidence of chronic GVHD was 57.5%. The Kaplan-Meier estimate of survival at 10 
      years was 54% [95% confidence interval (CI): 38-70%] and 31% (95% CI: 6-56%) for 
      patients with first chronic phase and more advanced diseases, respectively. 
      Multivariate analysis showed that younger age, absence of grade III-IV GVHD, the 
      use of busulphan and cyclophosphamide (BuCy) as preparative regimen, and 
      transplantation performed after January 1992 were factors associated with 
      improved survival. Patients who were 30 years of age or younger who had 
      transplantation done within 1 year after diagnosis during their first chronic 
      phase of disease had a particularly good prognosis, with a probability of 
      surviving 10 years of 72% (95% CI: 52-92%). We conclude that allogeneic HSCT 
      remains a feasible option for Asian patients with CML. The most favorable outcome 
      is observed in younger patients with early phase of the disease.
FAU - Koh, L P
AU  - Koh LP
AD  - Bone Marrow Transplantation Program, Department of Haematology, Singapore General 
      Hospital, Outram Road, 169608, Singapore. gheklp@sgh.gov.sg
FAU - Hwang, W Y K
AU  - Hwang WY
FAU - Tan, C H
AU  - Tan CH
FAU - Linn, Y C
AU  - Linn YC
FAU - Goh, Y T
AU  - Goh YT
FAU - Chuah, C T H
AU  - Chuah CT
FAU - Ng, H J
AU  - Ng HJ
FAU - Fook-Chong, S M C
AU  - Fook-Chong SM
FAU - Tan, P H C
AU  - Tan PH
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20031223
PL  - Germany
TA  - Ann Hematol
JT  - Annals of hematology
JID - 9107334
RN  - 0 (HLA Antigens)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Asian People
MH  - Cause of Death
MH  - Child
MH  - Child, Preschool
MH  - Feasibility Studies
MH  - Female
MH  - Follow-Up Studies
MH  - Graft vs Host Disease/epidemiology
MH  - HLA Antigens/*analysis
MH  - *Hematopoietic Stem Cell Transplantation/mortality
MH  - *Histocompatibility
MH  - Humans
MH  - Incidence
MH  - Leukemia, Myelogenous, Chronic, BCR-ABL Positive/*surgery
MH  - Male
MH  - Neoplasm Recurrence, Local
MH  - Prognosis
MH  - Risk Factors
MH  - Survival Analysis
EDAT- 2004/04/03 05:00
MHDA- 2004/05/27 05:00
CRDT- 2004/04/03 05:00
PHST- 2003/05/17 00:00 [received]
PHST- 2003/10/09 00:00 [accepted]
PHST- 2004/04/03 05:00 [pubmed]
PHST- 2004/05/27 05:00 [medline]
PHST- 2004/04/03 05:00 [entrez]
AID - 10.1007/s00277-003-0810-2 [doi]
PST - ppublish
SO  - Ann Hematol. 2004 May;83(5):286-94. doi: 10.1007/s00277-003-0810-2. Epub 2003 Dec 
      23.