Estudo retrospectivo do tratamento de leucemia mielóide aguda com o transplante de medula óssea: a experiência brasileira

• Autor(a) principal: Hamerschlak, Nelson
• Data de Publicação: 2006
• Outros Autores: Barton, Débora, Pasquini, Ricardo, Sarquis, Yana N., Ferreira, Eurípedes, Moreira, Frederico R., Colturato, Vergilio A. R., Souza, Carmino A., Voltarelli, Júlio, Piron-ruiz, Lilian, Setúbal, Daniela C., Zanichelli, Maria A., Castro, Cláudio G. De, Bueno, Nadjanara D., Seber, Adriana [UNIFESP], Rotolo, Marco A., Silla, Lucia M. R., Bittencourt, Henrique, Souza, Mair P., Vigorito, Afonso C., Brandalise, Silvia R., Maiolino, Angelo, Nucci, Marcio, Coelho, Érika, Ostronoff, Maurício, Simões, Belinda, Ruiz, Milton A.
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.1590/S1516-84842006000100005; http://repositorio.unifesp.br/handle/11600/2948
• topic: Acute myeloid leukemia; bone marrow transplantation; treatment; Leucemia mielóide aguda; transplante de medula óssea; tratamento

Data from the International Bone Marrow Transplant Registry (IBMTR) contribute for the improvement of Bone Marrow Transplant (BMT) worldwide. We studied the Brazilian experience in BMT for AML to compare this with international data. We performed a retrospective study by sending questionnaires to 16 BMT centers regarding clinical and treatment variables. Statistical analyses concerning autologous BMT (autoBMT) and allogeneic BMT (alloBMT) were performed using the Kaplan-Meier method and the log-rank test. All p-values were two-tailed. We collected data from 731 patients (205 autoBMT and 526 alloBMT). Median overall survival (OS) for autoBMT patients was longer than alloBMT patients (1035 vs. 466 days, p=0.0012). AlloBMT stem cell source (SCS): 73% bone marrow stem cell (BMSC), 23% peripheral blood stem cells (PBSC) and 4% umbilical cord blood. Among the autoBMT patients, the SCS was 63% PBSC, 22% BMSC and 15% both. The SCS did not impact on OS. There was no difference in OS between different FAB classifications in the alloBMT group, but in the autoBMT the M3 patients had longer survival. As expected, the main cause of mortality among autoBMT patients was related to disease relapse (60%), while in the alloBMT, to infection (38%). In both groups we found longer OS in first complete remission (1CR) compared to second (2CR) and other (p<0.0001), and longer OS in de novo AML than in secondary. In the alloBMT group we found more patients with advanced disease (60%), while in the autoBMT group, we found more M3 patients (24%), which could explain the difference in OS. Most of our results are in accordance with IBMTR data. One should consider the fact that this is a retrospective study and our findings should be analysed with caution.