Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023473 (chronic myeloid leukemia)
 18,916 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ten children between the ages of five and fifteen years old with leukemia (two with acute nonlymphocytic leukemia in first remission, four with acute lymphocytic leukemia in first or second remission, one with acute lymphocytic leukemia in relapse, and one with chronic myelocytic leukemia in chronic phase), malignant lymphoma (one) or severe aplastic anemia (one) were given transplants from HLA-matched or mismatched family members between March, 1982 and April, 1984. Two patients died of leukemia relapses on days 107 and 257 following transplantation. One patient died of cardiac failure on day 157. One patient who received HLA-mismatched marrow from his father died of pulmonary edema and acute graft versus host disease on day 32. Six are alive 268-843 days post transplantation. None of the ten patients developed interstitial pneumonia due to cytomegalovirus which is one of the major causes of death reported in other published studies.
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PMID:Allogeneic bone marrow transplantation in children: Tokai experience 1982 to 1984. 301 May 9

The probability of long term survival for allogeneic graft patients was 63% for ALL, 60% for ANL and 47% for CML in the 1st remission or 1st chronic phase of each leukemia. The major causes of death were interstitial pneumonia, relapse of leukemia and infections. On relationship of GVHD and the long term survival, the probability of 5 years survival was 38%, 47% and 25% in grade 0, I and II-IV of acute GVHD respectively. The difference might be due to that of relapse rate of leukemia. And the relationship between the relapse rate and GVHD, the patients with both of acute and chronic GVHD showed the lowest relapse rate 15.9%, the patients without GVHD showed the highest relapse rate 37.8% and the patients with either of GVHD showed the rate of between those of two groups. This may suggest that GVHD both acute and chronic might have an ability that can suppress the relapse of leukemia, i.e. GVL reaction. Interstitial pneumonia occurred in 32% of allograft patients and was often lethal complication (53%). Among many of prophylaxis tested, the followings were effective, a lower dose rate of total body irradiation, the selection of CMV-seronegative platelets donor, and the prophylactic administration of anti-CMV high titer globulin. Colony stimulating factor of human urine was also effective for shortening the granulopenic period after transplantation to prevent severe infections.
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PMID:[Allogeneic bone marrow transplantation]. 305 76

Results of HLA-identical allogeneic marrow transplantation were analyzed for 66 patients with accelerated-phase chronic myelogenous leukemia (CML). Multivariate proportional hazards regression models were used to determine disease-related and transplant-related factors associated with posttransplant mortality and relapse. The projected 5-year survival rate was estimated at 18% by the product-limit method. The major causes of death were interstitial pneumonia, infection, and relapse. Splenomegaly at initial diagnosis and longer time interval from diagnosis to transplant were associated with decreased overall survival and event-free survival. Sixteen patients have relapsed between 17 and 1,569 days (median, 486) posttransplant. The use of T-cell-depleted marrow and older age of the donor or recipient were associated with an increased probability of leukemic relapse. Ten of the 16 relapses occurred among the 15 patients who received T-cell-depleted marrow. The actuarial relapse risk 2.5 years posttransplant was 100% in patients administered T-cell-depleted marrow as compared with 25% in patients administered unmodified marrow. The data in this report emphasize the increased risks and relatively poor results that occur when marrow transplantation is deferred until after signs of acceleration appear. When compared with results for patients who received transplants during chronic phase, the poor results seen here in patients administered unmodified marrow stem primarily from increased transplant-related mortality rather than increased relapse risk. The strikingly increased relapse rate associated with the use of T-cell depletion would discourage its use for graft-v-host disease prevention in patients who receive transplants for CML.
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PMID:HLA-identical marrow transplantation during accelerated-phase chronic myelogenous leukemia: analysis of survival and remission duration. 305 33

Data from 208 patients with leukemia who were treated with allogeneic bone marrow transplantation between 1975 and 1985 were reported to the Japanese Bone Marrow Transplant Registry and were available for this analysis. These patients were classified into 82 of acute lymphocytic leukemia, 91 of acute non-lymphocytic leukemia, and 35 of chronic myelocytic leukemia. The incidence of interstitial pneumonitis (IP) was 39% (81/208) and fatality rate was 60% (49/81). Cytomegalovirus was the most frequent causative organism (54%). Using Cox's proportional hazard regression model, age of recipient (P = 0.0068), status of disease (P = 0.0191), and number of platelet transfusion (P = 0.0425) were found to be significant risk factors associated with IP. Probabilities of developing IP at three years were 65% and 42% in single dose and fractionated total body irradiation (TBI), respectively. In single dose TBI group, dose-rate affected the incidence of IP. On the contrary, in fractionated TBI group, number of fractions as well as dose-rate had no impact on the incidence of IP.
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PMID:Interstitial pneumonitis following allogeneic bone marrow transplantation in the treatment of leukemia based on BMT survey in Japan. 306 Oct 43

Utilization of bone marrow transplantation as a therapeutic modality continues to increase. During the 32 years between 1955 and 1986 more than 15,000 patients received allogeneic transplants; more than 50% of these were performed in the 3 years, 1984 to 1986. Transplantation is an effective therapy for acute leukemias; in some instances it is the preferred treatment. In chronic myelogenous leukemia, aplastic anemia, and some genetic and immune deficiency diseases, bone marrow transplantation provides the only possibility for cure. Bone marrow transplantation is investigational in other conditions and is associated with substantial problems such as graft-vs-host disease, interstitial pneumonitis, and the requirement for an HLA-identical donor. Recently an increasing number of transplants have been performed using HLA partially or fully matched related or unrelated donors with some success. The development of AGVHD and interstitial pneumonitis can to some extent be predicted by risk factor assessment. AGVHD can be prevented by depletion of T cells from the donor bone marrow but this is associated with an increased risk of graft rejection and leukemia relapse. Interstitial pneumonitis can be modified by prophylaxis with CMV immune globulin and by the use of CMV-negative blood donors. In this report we summarized data from the International Bone Marrow Transplant Registry concerning allogeneic bone marrow transplantation in leukemia.
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PMID:Current status of allogeneic bone marrow transplantation in leukemia: a report from the International Bone Marrow Transplant Registry. 315 78

Bone marrow transplantation is widely used to treat hematologic, immune, and genetic diseases. More than 9,500 transplants have been performed by 199 transplant teams worldwide; 162 are currently active. The annual rate of allogeneic bone marrow transplants now exceeds 2,500 plus more than 1,000 autotransplants annually. Transplantation is an effective therapy for acute leukemias; in some instances, it is the preferred treatment. In chronic myelogenous leukemia, aplastic anemia, and some genetic and immune diseases, bone marrow transplantation provides the only possibility for cure. Bone marrow transplantation remains investigational in many conditions and is associated with substantial problems such as GvHD, interstitial pneumonitis, and the requirement for an HLA-identical donor. Recently an increasing number of transplants have been performed using HLA partially or fully matched, related or unrelated donors with some success. The development of GvHD and interstitial pneumonitis can, to some extent, be predicted by risk-factor assessment. Although GvHD can be prevented by depleting T cells from the donor bone marrow, this is associated with an increased risk of graft rejection and leukemia relapse. Interstitial pneumonitis can be modified by prophylaxis with CMV-immune globulin and by the use of CMV-negative blood donors. In this report, we summarized data from the International Bone Marrow Transplant Registry concerning allogeneic bone marrow transplantation in man.
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PMID:Current status of allogeneic bone marrow transplantation: a report from the International Bone Marrow Transplant Registry. 315 98

One hundred seventy-nine patients with acute nonlymphoblastic leukemia in first remission (n = 75), chronic myelocytic leukemia in chronic or accelerated phase (n = 48) or leukemia in advanced stage (n = 56) were given HLA-identical marrow grafts and randomized to receive methotrexate or cyclosporine for prevention of graft-v-host disease (GVHD). The current report updates the three prospective trials with follow-ups ranging from 3.2 to 6.2 years after marrow grafting. Results were analyzed separately for each individual study and for all three studies combined. Overall, 40% of patients given cyclosporine and 55% of those given methotrexate developed acute GVHD (P = .13); the incidence of chronic GVHD was 42% and 48%, respectively (P = .67). Twenty-two percent of cyclosporine-treated patients and 30% of methotrexate-treated patients developed interstitial pneumonia of any etiology (P = .25), and the figures for cytomegalovirus pneumonia were 18% and 20%, respectively (P = .41). The overall incidence of leukemic relapse was 31% in cyclosporine-treated patients and 36% in methotrexate-treated patients (P = .75). The probabilities of survival for cyclosporine-v methotrexate-treated patients were comparable for all three study groups: 52% v 48% in patients with acute nonlymphoblastic leukemia (P = .42), 55% v 60% for those with chronic myelocytic leukemia (P = .61), 12% and 12% for those with advanced leukemia (P = .93), and 39% v 38% overall (P = .72). We conclude that cyclosporine and methotrexate are comparable regarding the likelihood of acute/chronic GVHD, interstitial pneumonia, leukemic relapse, and long-term survival.
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PMID:Cyclosporine v methotrexate for graft-v-host disease prevention in patients given marrow grafts for leukemia: long-term follow-up of three controlled trials. 327 60

We treated 73 patients with hematologic malignancies in first complete remission (acute lymphoblastic leukemia = 23 patients; acute non-lymphoblastic leukemia = 25 patients; chronic myelogenous leukemia in first chronic phase = 20 patients, and high grade lymphoma = five patients) with a uniform preparative regimen consisting of fractionated total body irradiation (1,320 cGy) and high dose cyclophosphamide (100 mg/kg), followed by allogeneic bone marrow transplantation. By radiation dosimetry we demonstrated that the calculated doses were delivered accurately and reproducibly. Actuarial survival rates (+/- SEM) in complete remission were as follows: Acute lymphoblastic leukemia = 74 +/- 9%; acute nonlymphoblastic leukemia = 50 +/- 11%; and chronic myelogenous leukemia = 55 +/- 11%. Actuarial relapse rates for these three diagnoses were 19 +/- 9%, 17 +/- 11%, and 0% respectively. Three of the five lymphoma patients are alive in complete remission at 22+, 28+, and 54+ months. Overall probability of survival for the 73 patients was 59 +/- 7%. Interstitial pneumonia, usually associated with cytomegalovirus infection and graft-versus-host disease, and relapse of the underlying malignancy were the major causes of death.
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PMID:Fractionated total body irradiation and high dose cyclophosphamide: a preparative regimen for bone marrow transplantation for patients with hematologic malignancies in first complete remission. 329 91

Between August 1979 and April 1986, we treated 70 patients with chronic myeloid leukemia by supralethal chemoradiotherapy followed by bone marrow transplantation (BMT) from HLA identical sibling donors (65 patients) or from identical twins (5 patients). All patients were splenectomized before BMT. To prevent graft versus host disease Cyclosporin alone or associated with Methotrexate was given; in addition 13 patients received a T cell depleted marrow. All patients showed engraftment. Of the 5 patients treated by syngenic BMT, 2 patients relapsed but all are alive in remission, 2 of them after a successful second BMT. Of the 36 patients treated by allogeneic BMT in the chronic phase, 20 are alive in unmaintained remission after a median follow-up of 24 months (range 6 to 58). No patients have relapsed. The actuarial survival at 2 years was 60%. Of the 29 patients with more advanced disease, 19 have survived with the actuarial survival at 2 years 50%. We conclude that the probability of cure after BMT is very high, especially if BMT is performed while the patient remains in the chronic phase. Only 3 patients grafted in accelerated or blast phase died with relapse. The main cause of death was interstitial pneumonitis (15 patients) and 10 patients died from other transplant-related complications.
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PMID:[Allogenic bone marrow grafts in chronic myeloid leukemia]. 329 74

Bone marrow transplantation (BMT) after intensive marrow-lethal chemotherapy and total body irradiation has made remarkable progress in recent years. In allogeneic BMT, HLA-matched marrow cells of siblings are used, while in autologous BMT, cryopreserved leukemia-purged marrow cells from patients are employed. In 1985, about 100 BMT cases were registered in the Japan BMT study group. Interstitial pneumonitis caused by cytomegalovirus, relapse of leukemia, graft versus host disease, and bacterial infection were major cases of failure, which have shown a markedly reduced tendency in recent years. The timing of BMT was found to be very important for the survival of patients. In cases with acute lymphoblastic leukemia, if BMT was performed in the first remission, the long survival rate was 76%, while this rate was low for second or subsequent remissions. It was also found in patients with chronic myelogenous leukemia, that the survival rate was high in the chronic phase and low in the accelerated or blastic phase. BMT seems to be a very promising therapy for leukemia and related malignant diseases with a very high possibility of complete cure.
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PMID:[Bone marrow transplantation after intensive chemotherapy]. 329 59


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