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Cutler, Corey S.; Lee, Stephanie J.; Greenberg, Peter; Deeg, H. Joachim; Pérez, Waleska S.; Anasetti, Claudio; Bolwell, Brian J.; Cairo, Mitchell S.; Gale, Robert Peter; Klein, John P.; Lazarus, Hillard M.; Liesveld, Jane L.; McCarthy, Philip L.; Milone, Gustavo A.; Rizzo, J. Douglas; Schultz, Kirk R.; Trigg, Michael E.; Keating, Armand; Weisdorf, Daniel J.; Antin, Joseph H.; Horowitz, Mary M.
Blood, 07/2004, Letnik: 104, Številka: 2Journal Article
Bone marrow transplantation (BMT) can cure myelodysplastic syndrome (MDS), although transplantation carries significant risks of morbidity and mortality. Because the optimal timing of HLA-matched BMT for MDS is unknown, we constructed a Markov model to examine 3 transplantation strategies for newly diagnosed MDS: transplantation at diagnosis, transplantation at leukemic progression, and transplantation at an interval from diagnosis but prior to leukemic progression. Analyses using individual patient risk-assessment data from transplantation and nontransplantation registries were performed for all 4 International Prognostic Scoring System (IPSS) risk groups with adjustments for quality of life (QoL). For low and intermediate-1 IPSS groups, delayed transplantation maximized overall survival. Transplantation prior to leukemic transformation was associated with a greater number of life years than transplantation at the time of leukemic progression. In a cohort of patients under the age of 40 years, an even more marked survival advantage for delayed transplantation was noted. For intermediate-2 and high IPSS groups, transplantation at diagnosis maximized overall survival. No changes in the optimal transplantation strategies were noted when QoL adjustments were incorporated. For low- and intermediate-1-risk MDS, delayed BMT is associated with maximal life expectancy, whereas immediate transplantation for intermediate-2- and high-risk disease is associated with maximal life expectancy. (Blood. 2004;104:579-585)
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Leto | Faktor vpliva | Izdaja | Kategorija | Razvrstitev | ||||
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JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
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Povezave do osebnih bibliografij avtorjev | Povezave do podatkov o raziskovalcih v sistemu SICRIS |
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Vir: Osebne bibliografije
in: SICRIS
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