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Title   급성전골수성백혈병에서 조혈모세포이식과 화학요법의 장기생존율 비교 ( Autologous or Allogeneic Bone Marrow Transplantation Compared with Consolidation Chemotherapy in Acute promyelocytic Leukemia )
Publicationinfo   1999 Jan; 031(02): 331-339.
Key_word   Acute promyelocytic leukemia, Consolidation chemotherapy, Bone marrow transplantation
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Abstract   Purpose: Acute promyelocytic leukemia (APL) is a distinct subtype of acute myelogenous leukemia characterized by the morphology of blast cells (M3 in FAB classification), the t (15;17) translocation, and a coagulopathy combining disseminated intravascular coagulation and fibrinolysis. It has been considered to have better response to combination chemo- therapy of an anthracycline and cytosine arabinoside and a higher cure rate than other subtypes because of recent approach of differentiating leukemic blasts by all-trans- retinoic acid (ATRA). The role of stem cell transplantation in APL has to be determined in comparison with that of consolidation chemotherapy. Materials and Methods: We compared the leukemia-free survival and overall survival between APL patients receiving the consolidation chemotherapy and those undergoing the allogeneic or autologous stem cell transplantation following the high-dose anticancer therapy. Of the 65 patients achieving the first complete remission from 1992 to 1997, 33 patients were treated with 3 courses of consolidation chemotherapies and 32 with the stem cell transplantation. Results: With a median follow-up of 22 months (8-60), the actuarial leukemia-free survival at 3 years was significantly higher in transplantation group than in chematherapy group (73.8% versus 33.5%; P=0.0087), and the probability of leukemic relapse was con- siderably lower in transplantation group than in chemotherapy group (6.3% versus 57.5%; P=0.001). The treatment-related mortalities of the groups were 0% in chemotherapy group and 14.3% in transplantation group. The main cause of deaths was relapse in the consolidation chemotherapy group. Conclusion: These data demonstrate that the stem cell transplantation results in better leukemia-free survival than the consolidation chemotherapy for patients with APL in the first complete remission because of lower risk of relapse.
저 자   민창기(Chang Ki Min),민우성(Woo Sung Min),김희제(Hee Je Kim),엄현석(Hyun Suk Eom),이종욱(Jong Wook Lee),한경자(Kyungja Han),최일봉(Ihl Bhong Choi),김춘추(Chun Choo Kim),김원일(Won IL Kim),김동집(Dong Jip Kim)