title: Extramedullary relapse after allogeneic bone marrow transplantation for haematological malignancy.
abstract: We describe the risk factors for and the natural history and response to treatment of extramedullary (EM) relapse in 183 patients who underwent allogeneic bone marrow transplantation (alloBMT) for a variety of haematological malignancies at our institution over a 7 1/2 year period. Fifty-one patients relapsed; 15 had EM relapse either alone or in association with marrow involvement. A retrospective analysis found that the presence of chronic GVHD and a longer interval between transplant and relapse were independently associated with an increased risk of EM compared to marrow-only relapse. EM relapse was also associated with a longer post-relapse survival. Patients with EM relapse appeared to respond to cytotoxic therapy but not to DLI. EM relapse after alloBMT may be more common than previously thought and have a better prognosis than marrow-only relapse. While patients developing chronic GVHD after alloBMT have a lower overall relapse risk than those who do not, they may be more prone to delayed relapse at EM sites.
authors: Department of Clinical Haematology and Medical Oncology, Royal Melbourne Hospital, Parkville, Victoria, Australia.
authors: G
authors: G
authors: Chong
authors: G
authors: G
authors: Byrnes
authors: J
authors: J
authors: Szer
authors: A
authors: A
authors: Grigg
mesh_terms: D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D001842:Bone and Bones / Q000473:pathology; D001940:Breast / Q000473:pathology; D002908:Chronic Disease; D015331:Cohort Studies; D003131:Combined Modality Therapy; D004198:Disease Susceptibility; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000453:epidemiology; D019337:Hematologic Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D006801:Humans; D008297:Male; D008578:Meninges / Q000473:pathology; D008875:Middle Aged; D009305:Nasopharynx / Q000473:pathology; D010179:Pancreas / Q000473:pathology; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D016879:Salvage Therapy; D016019:Survival Analysis; D013737:Testis / Q000473:pathology; D013997:Time Factors; D014184:Transplantation, Homologous / Q000009:adverse effects; D017211:Treatment Failure