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Allogeneic Stem Cell Transplantation (Current Clinical by Mary J. Laughlin, Hillard M. Lazarus

By Mary J. Laughlin, Hillard M. Lazarus

The world over well-known physicians and researchers evaluate either the fundamentals of allogeneic stem cellphone transplantation and up to date advances within the box, rather as they relate to antitumor results and graft-versus-host disorder additionally they supply precise decision-tree analyses to steer clinicians in making a choice on and dealing with their allogeneic transplant sufferers. The thoughts mentioned conceal a number of parts, starting from stem cellphone mobilization in common donors, to symptoms for allogeneic transplantation except hematologic malignancies, to using nonmyeloablative conditioning regimens. The authors additionally discover new advancements within the optimum collection of unrelated allogeneic grafts (e.g., matched unrelated donor, partly mismatched friend, or umbilical wire blood), the use allogeneic peripheral blood stem mobile vs marrow-derived grafts for transplantation, and the kinetics of immune reconstitution after transplantation.

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Sample text

Weighting these variables by their statistical power separated patients into four distinctive subgroups of risk. Patients receive a separate score based on percentage of marrow blasts, karyotype, and information on cytopenias. These scores are then combined into a total score which is then used to predict progression to AML, as well as for median survival (58). , analyzed data for all MDS patients transplanted in Seattle from 1981 to 1996, using multivariate analysis to determine factors predictive for nonrelapse mortality, relapse, and DFS.

Laughlin and Hillard M. , Totowa, NJ 29 30 Part II / Disease Indications: Allogeneic Transplantation Fig. 1. Adverse prognostic features in adult ALL. than 60 yr, a high white blood cell count (WBC) at presentation, and failure to achieve a clinical remission within the first 4 wk of treatment are all considered adverse clinical features. The detection of specific recurring cytogenetic abnormalities has emerged as the most important prognostic factor for risk stratification of adults with ALL. Clonal chromosomal aberrations can be detected in cells from 62 to 85% of adult ALL patients, and several studies have shown their significance as predictors of outcome (2,3).

Keating S, Suciu S, de Witte T, et al. Prognostic factors of patients with acute myeloid leukemia (AML) allografted in first complete remission: an analysis of the EORTC-GIMEMA AML 8A trial. The European Organization for Research and Treatment of Cancer (EORTC) and the Gruppo Italiano Malattie Ematologiche Maligne dell’ Adulto (GIMEMA) Leukemia Cooperative Groups. Bone Marrow Transplant 1996;17:993–1001. 7. Löwenberg B, Downing J, Burnett A. Acute myeloid leukemia. N Engl J Med 1999;341:1051–1062.

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