| Topic: | hematologic diseases (he) |
| Title: | Which Patients with Adult Acute Lymphoblastic Leukemia Should Undergo a Hematopoietic Stem Cell Transplantation? Case-Based Discussion. |
| Author: | Lazarus, H.M.; Luger, S. |
| Source: | IN: Hematology 2007.Washington, DC: American Society of Hematology. 2007. pp 444-452. |
| Availability: | Available from American Society of Hematology. 1900 M Street NW, Suite 200, Washington, DC 20036. Email: ASH@hematology.org. Website: www.asheducationbook.org. Price: Available free of charge on website. |
| Abstract: | This chapter, from the Hematology 2007 monograph, considers the factors involved in the decision to proceed to hematopoietic stem cell transplant (HSCT) for adult patients with acute lymphoblastic leukemia (ALL). The authors note that relapse and nonrelapse mortality continue to plague the outcome of HSCT even when undertaken in complete remission (CR). Those considered to be at high risk for relapse often are considered for HSCT in first complete remission (CR1), whereas those at lower risk may not be referred until they have relapsed, when their chances for cure are very poor. In some patients who have a suitable histocompatible sibling, disease- or patient-related factors may override the potential benefit of allogeneic HSCT. Because many patients do not have a suitable histocompatible sibling, one has to consider the relative merits of autologous transplantation versus use of an alternative allogeneic stem cell source such as a matched-unrelated donor (MUD), umbilical cord blood (UCB) donor, or haploidentical donor. Deciding among these options versus chemotherapy—even in high-risk patients—is difficult. In the review, the authors discuss the risks and benefits of these choices to determine whether and by what means to proceed to HSCT in adult patients with ALL who are in CR1. The authors present two case studies of patients with ALL and a discussion of how the data provided would lead to a decision about the selection of therapy. 1 figure. 3 tables. 52 references. |
| Format: | Monograph/Book |
| Language: | English. |
| Major Keywords: | Hematologic Diseases. Stem Cells. Transplantation. Patient Selection. Leukemia. Myelodysplastic Syndromes. Morbidity. Mortality. |
| Minor Keywords: | Cancer Therapy. Patient Care Management. Case Reports. Risk Factors. Age Factors. Remission. Blood Donation. Histocompatibility. Chemotherapy. |
| Publication Number: | HEBK10258 |
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