Allogeneic and Autologous Stem Cell Transplantation for Acute Leukemia and Myelodysplasia in the Adult

摘要: Acute lymphoblastic leukemia (ALL) is characterized by clonal proliferation, accumulation, and tissue infiltration of immature lymphoid cells the bone marrow. Although ALL accounts for approx 80% childhood leukemias in United States, a second peak occurs around age 50 there an increase incidence with increasing age. Age greater than 60 yr, leukocyte count 30,000, non-T-cell phenotype, lack mediastinal adenopathy, poor performance status at diagnosis, Philadelphia chromosome (Ph)+ cytogenetic analysis, as well finding other chromosomal translocations such t(4;11), t(1;19), or t(8;14) all predict outcome even aggressive chemotherapy. Those patients requiring more 4 wk induction therapy to achieve remission also have poorer prognosis (1–4).