By B. Juan Chahinian
Botany
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Extra resources for The Splendid Sansevieria
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3 Allogeneic Hematopoietic Stem Cell Transplantation.......................................... 4 Autologous Hematopoietic Stem Cell Transplantation........................................ 7 Characteristics of and Therapy for AML Subtypes.......................................................... 1 Acute Promyelocytic Leukemia (APL, M3)......................................................... 2 Acute Myelomonocytic and Acute Monocytic Leukemia (M4, M5)................... 3 Erythroleukemia (Di Guglielmo Syndrome, M6).................................................
1, page 9). 3 Allogeneic Hematopoietic Stem Cell Transplantation • The possibility of an antileukemic effect of the donor immune system (graft vs leukemia or GVL), together with supportive therapy and prophylaxis against graft-versus-host disease (GVHD), results in an improved outcome for certain subtypes of AML (see discussion above) • A GVL effect is less effective in transplantation between identical twins or after extensive T-cell depletion of the donor stem cells • Adverse late sequelae after transplantation include chronic GVHD, growth retardation, sterility, and the risk of secondary malignancy • The frequency of leukemia-free survival after transplantation is 50–70% In the absence of an HLA matched, family donor, matched or mismatched unrelated bone marrow or cord blood donors may be used; in some instances, related haploidentical donor transplantation may be considered.
2 Leukostasis • If WBC is higher than 200 × 109/l, leukemic blasts may clump intravascularly. 3 Tumor Lysis Syndrome See Chap. 18. 6 Therapy • Before 1970, nearly all children with AML died. Since then cooperative study protocols with different cytotoxic drug combinations have led to long-term remission in approximately 50–60% of children (see also table Prognostic factors in AML) • Allogeneic hematopoietic stem cell transplantation (HSCT) has been reported in multiple studies to improve disease-free survival but not always overall survival because of treatment-related mortality.