Уважаемый коллега Terro!



Как бы Вы могли прокомментировать следующие цитаты:



Autologous stem cell rescue



Overall survival is not significantly different between patients in CR1 treated with chemotherapy and those who were autografted. This is especially true for those patients who received high-dose cytarabine as consolidation.

Given these results and the long-term effects on fertility, sexual health, quality of life and second malignancy, autografting is not standard therapy for CR1 on a type 1 level of evidence. It may be suitable for individual clinical use in CR2 on a type 3 level of evidence. These include children, those with a long CR1 or those with favourable cytogenetics.



Allogeneic stem cell transplantation



Unfortunately problems regarding conditioning regimen-related toxicity, graft-versus-host disease (GVHD) and infection result in a 20–25% transplant-related mortality and generally limit the procedure to those under 50 year-old.



The disadvantage of allografting in CR1 is that it exposes patients who are potentially cured with chemotherapy alone to the one in four risk of death from a transplant procedure and the long-term morbidity of chronic GVHD. It has therefore been argued that it is better to allograft in early relapse or CR2, if that can be achieved.

There have been no direct randomised comparisons of chemotherapy and allografting although some studies using so-called biological randomisation between donor/no donor have shown a benefit for allografting in CR1 in certain subgroups. In general, the relapse risk is less for allografting, but there is no overall survival benefit.



Из Crit Rev Oncol Hematol. 2004 Jun;50(3):197-222.

Adult acute myeloid leukaemia.

Smith M, Barnett M, Bassan R, Gatta G, Tondini C, Kern W.