PMID- 9045297
OWN - NLM
STAT- MEDLINE
DCOM- 19970303
LR  - 20160422
IS  - 0093-7754 (Print)
IS  - 0093-7754 (Linking)
VI  - 24
IP  - 1
DP  - 1997 Feb
TI  - Allogeneic hematopoietic stem cell transplantation for acute leukemia.
PG  - 114-23
AB  - Allogeneic transplantation is the only form of therapy that enables physicians to 
      cure patients with acute myeloid leukemia (AML) and acute lymphoblastic leukemia 
      (ALL) who do not respond to induction therapy. Thus, patients and family members 
      should be human leukocyte antigen (HLA)-typed soon after the diagnosis to 
      expedite transplantation should induction therapy fail. Transplantation is 
      superior to chemotherapy in patients with AML in second remission. The role of 
      transplantation in ALL other than induction failure is somewhat different in 
      children than in adults. Transplantation appears to be the treatment of choice in 
      children with ALL in second remission regardless of the characteristics of the 
      disease. Adults who relapse off-therapy after prolonged remission should probably 
      be reinduced, whereas those with short remissions probably should go directly to 
      transplant. Transplants from family members incompatible for one antigen result 
      in survival rates similar to those observed with HLA-identical sibling 
      transplants, but transplants from family donors mismatched for two or three 
      antigens have been associated with a substantial increase in graft-versus-host 
      disease (GVHD) and other complications and such transplants should be reserved 
      for patients with few other prospects for cure. Randomized trials are underway to 
      compare peripheral blood stem cells mobilized with granulocyte colony stimulating 
      factor to marrow for H LA-matched transplantation. Results with unrelated donor 
      transplants have improved with time and are approaching those for matched sibling 
      transplants. Early results suggest that umbilical cord blood transplants are 
      feasible with more graft failure but less GVHD than with unmodified marrow.
FAU - Appelbaum, F R
AU  - Appelbaum FR
AD  - Fred Hutchinson Cancer Research Center, University of Washington School of 
      Medicine, Seattle 98104, USA.
LA  - eng
GR  - CA-18029/CA/NCI NIH HHS/United States
GR  - CA-18221/CA/NCI NIH HHS/United States
GR  - CA-26386/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, U.S. Gov't, P.H.S.
PT  - Review
PL  - United States
TA  - Semin Oncol
JT  - Seminars in oncology
JID - 0420432
SB  - IM
MH  - Acute Disease
MH  - Graft vs Host Disease
MH  - *Hematopoietic Stem Cell Transplantation
MH  - Histocompatibility Testing
MH  - Humans
MH  - Leukemia, Myeloid/*therapy
MH  - Precursor Cell Lymphoblastic Leukemia-Lymphoma/*therapy
MH  - Transplantation Conditioning
MH  - Transplantation, Homologous
RF  - 45
EDAT- 1997/02/01 00:00
MHDA- 1997/02/01 00:01
CRDT- 1997/02/01 00:00
PHST- 1997/02/01 00:00 [pubmed]
PHST- 1997/02/01 00:01 [medline]
PHST- 1997/02/01 00:00 [entrez]
PST - ppublish
SO  - Semin Oncol. 1997 Feb;24(1):114-23.