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Lower leukemia relapse in pediatric patients with pulmonary cytolytic thrombi following allogeneic transplant. Bone Marrow Transplant 2011 Mar;46(3):368-71

Date

06/16/2010

Pubmed ID

20548337

Pubmed Central ID

PMC3556271

DOI

10.1038/bmt.2010.119

Scopus ID

2-s2.0-79952535218   5 Citations

Abstract

Pulmonary cytolytic thrombi (PCT) is an uncommon complication after hematopoietic cell transplantation. Although the pathogenesis is unknown, patients typically respond to systemic corticosteroid treatment. Considering corticosteroids may impair GVL reactions, we reviewed the records of 324 pediatric patients who received a transplant for leukemia and compared the outcomes of those with PCT (n=14) to those without PCT (n=310). PCT patients had a significantly more acute GVHD (aGVHD) and chronic GVHD (cGVHD). Though 3-year non-relapse mortality and OS were similar, there was significantly less relapse in patients with PCT compared to those without PCT (0 vs 28%, P=0.02), regardless of the presence or absence of aGVHD. In multivariate analysis, grade II-IV aGVHD (P=0.02), cGVHD (P=0.01) and development of PCT (P<0.01) were independently associated with less relapse. These data suggest that patients with PCT are at greater risk for GVHD, but at lower risk of leukemia relapse.

Author List

Smith AR, Gulbahce E, Burke MJ, Cao Q, Macmillan ML, Tolar J, Orchard PJ, Blazar BR, Baker KS, Wagner JE, Verneris MR

Author

Michael James Burke MD Professor in the Pediatrics department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adolescent
Child
Child, Preschool
Cord Blood Stem Cell Transplantation
Female
Graft vs Host Disease
Hematopoietic Stem Cell Transplantation
Humans
Leukemia
Male
Multivariate Analysis
Pulmonary Embolism
Recurrence
Transplantation Conditioning
Treatment Outcome
jenkins-FCD Prod-482 91ad8a360b6da540234915ea01ff80e38bfdb40a