By Frederick R. Appelbaum MD (auth.), Mary J. Laughlin MD, Hillard M. Lazarus MD (eds.)
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Chapter 2 / Allogeneic BMT for AML 23 Fig. 3. DFS for a group of patients with AML undergoing allogeneic transplantation after having failed to achieve a remission with either conventional dose of ARA-C or high-dose ARA-C and an anthracycline. Patients with intermediate cytogenetics had a better DFS than those with unfavorable cytogenetics. Overall, the actual probability of DFS at 3 yr was 44% for patients with intermediate cytogenetics and 18% for those with unfavorable cytogenetics. plant outcome as well as relapse.
The primary objectives of this study will be to determine the ability of STI-571 to produce a complete molecular response (achieve BCR/ABL status by reverse transcription PCR [RTPCR]) following sequential chemotherapy, STI-571, and transplantation, and to determine the ability of STI-571 to prolong DFS and overall survival in this high-risk group of patients. 1. Predicting Outcome: Role of Monitoring MRD in Ph+ ALL Following Transplantation Several studies of MRD status following allogeneic transplantation provide intriguing information about the risk of relapse in Ph+ ALL and may help to identify patients who are likely to relapse (45–49).
The 10-yr overall survival rate of patients greater than 50 yr treated with chemotherapy only was 27%. 6). After stratification into high and standard risk, there was still no statistical difference between these two groups. High risk was defined as having one or more of the following factors: presence of the Ph chromosome, null ALL, age > 35 yr, WBC count > 30 × 109/L, time to CR >4 wk. 04). 6) (18,19). Thus, both the large IBMTR retrospective review and the LALA study suggest a clear role for allogeneic SCT over consolidation chemotherapy in younger adults with high-risk features in CR1.
Allogeneic Stem Cell Transplantation: Clinical Research and Practice by Frederick R. Appelbaum MD (auth.), Mary J. Laughlin MD, Hillard M. Lazarus MD (eds.)