At present, peripheral blood is the most commonly used source of stem cells for both autologous and allogeneic grafts. Hematopoietic stem-cell transplantation can be either autologous (meaning that the stem cells are collected from the recipient) or allogeneic (meaning that the cells come from another individual or one or more umbilical cord blood units.īefore the introduction of granulocyte colony–stimulating factor, stem cells were harvested directly from donor bone marrow in the operating room 4. Stem cells can be obtained from peripheral blood, bone marrow, or umbilical cord units. All rights reserved.In general, a hsct can be classified by the source of the graft and by the relationship of the donor and recipient. AML relapse after alloHCT predicted poor survival however, patients who relapsed ≥6 months after their initial alloHCT had better survival and may benefit from intensive therapy, such as second alloHCT ± DLI.Īcute myeloid leukemia Allogeneic transplantation Donor lymphocyte infusion Relapse Second transplantation.Ĭopyright © 2015 American Society for Blood and Marrow Transplantation. 0008), and use of cord blood for first HCT (relative risk, 1.23 95% CI, 1.06 to 1.42 P =. 0001), active graft-versus-host disease at relapse (relative risk, 1.25 95% CI, 1.13 to 1.39 P <. Median follow-up after relapse was 39 months (range, 40 years (relative risk, 1.42 95% CI, 1.24 to 1.64 P <. At relapse, 1231 patients (69%) received intensive therapy, including chemotherapy alone (n = 660), donor lymphocyte infusion (DLI) ± chemotherapy (n = 202), or second alloHCT ± chemotherapy ± DLI (n = 369), with subsequent CR rates of 29%. Median time to post-HCT relapse was 7 months (range, 1 to 177). We studied outcomes of 1788 AML patients relapsing after alloHCT (1990 to 2010) during first or second complete remission (CR) to identify factors associated with longer postrelapse survival.
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