PURPOSE: Nucleated cell dose is an important and modifiable factor in hematopoietic stem cell transplantation (HSCT), however its association with outcomes in the context of reduced intensity conditioning regimen (RIC) HSCT for adults with acute myelocytic leukemia (AML) is not known. PATIENTS AND METHODS: From 1998 to 2003, 253 patients with de novo AML, received transplants with RIC and peripheral blood from a genoidentical donor. Median age was 55 years (range, 18 to 72) and the median follow-up was 17 months (range, 2 to 67). One hundred forty one patients received transplants in first remission (CR1), 47 received transplants in second remission (CR2), and 65 patients received transplants in a more advanced phase. Fludarabin-based RIC was used in 91% of patients and low-dose (< 4 Gy) total-body radiation in 23% of patients. The median nucleated and CD34 cell dose infused were 9.1x 10(8)/kg and 5.8x 10(6)/kg, respectively. RESULTS: Overall, 2-year leukemia-free survival (LFS) was 41% +/- 4% and it was 46% +/- 5% for patients receiving a higher cell dose (> 9.1x 10(8)/kg) and 37% +/- 5% for the remainders (P = .03). Higher cell doses exclusively benefited patients who received transplantations in CR2 or beyond, with LFS of 47 +/- 8 versus 20 +/- 8, with no detectable effect for patients who received transplants in CR1. In a multivariate analysis of the overall patient population, higher nucleated cell dose cells were associated with higher LFS (P = .04), higher incidence of chronic graft-versus-host disease (P = .01), and there was a trend towards a lower relapse incidence (P = .06). Interestingly, CD34+ cell dose was not associated with any outcomes. CONCLUSION: Nucleated cell dose is an important factor that can be modified to improve results of RIC for patients with AML transplanted later than in CR1.
PURPOSE: Nucleated cell dose is an important and modifiable factor in hematopoietic stem cell transplantation (HSCT), however its association with outcomes in the context of reduced intensity conditioning regimen (RIC) HSCT for adults with acute myelocytic leukemia (AML) is not known. PATIENTS AND METHODS: From 1998 to 2003, 253 patients with de novo AML, received transplants with RIC and peripheral blood from a genoidentical donor. Median age was 55 years (range, 18 to 72) and the median follow-up was 17 months (range, 2 to 67). One hundred forty one patients received transplants in first remission (CR1), 47 received transplants in second remission (CR2), and 65 patients received transplants in a more advanced phase. Fludarabin-based RIC was used in 91% of patients and low-dose (< 4 Gy) total-body radiation in 23% of patients. The median nucleated and CD34 cell dose infused were 9.1x 10(8)/kg and 5.8x 10(6)/kg, respectively. RESULTS: Overall, 2-year leukemia-free survival (LFS) was 41% +/- 4% and it was 46% +/- 5% for patients receiving a higher cell dose (> 9.1x 10(8)/kg) and 37% +/- 5% for the remainders (P = .03). Higher cell doses exclusively benefited patients who received transplantations in CR2 or beyond, with LFS of 47 +/- 8 versus 20 +/- 8, with no detectable effect for patients who received transplants in CR1. In a multivariate analysis of the overall patient population, higher nucleated cell dose cells were associated with higher LFS (P = .04), higher incidence of chronic graft-versus-host disease (P = .01), and there was a trend towards a lower relapse incidence (P = .06). Interestingly, CD34+ cell dose was not associated with any outcomes. CONCLUSION: Nucleated cell dose is an important factor that can be modified to improve results of RIC for patients with AML transplanted later than in CR1.
Authors: Lisa M Crisalli; Joanne T Hinkle; Christopher C Walling; Mary Sell; Noelle V Frey; Elizabeth O Hexner; Alison W Loren; Selina M Luger; Edward A Stadtmauer; David L Porter; Ran Reshef Journal: Biol Blood Marrow Transplant Date: 2018-02-02 Impact factor: 5.742
Authors: Boglarka Gyurkocza; Rainer Storb; Barry E Storer; Thomas R Chauncey; Thoralf Lange; Judith A Shizuru; Amelia A Langston; Michael A Pulsipher; Christopher N Bredeson; Richard T Maziarz; Benedetto Bruno; Finn B Petersen; Michael B Maris; Edward Agura; Andrew Yeager; Wolfgang Bethge; Firoozeh Sahebi; Frederick R Appelbaum; David G Maloney; Brenda M Sandmaier Journal: J Clin Oncol Date: 2010-05-03 Impact factor: 44.544
Authors: Boglarka Gyurkocza; Jonathan Gutman; Eneida R Nemecek; Merav Bar; Filippo Milano; Aravind Ramakrishnan; Bart Scott; Min Fang; Brent Wood; John M Pagel; Joachim Baumgart; Colleen Delaney; Richard T Maziarz; Brenda M Sandmaier; Elihu H Estey; Frederick R Appelbaum; Barry E Storer; Hans Joachim Deeg Journal: Biol Blood Marrow Transplant Date: 2014-01-16 Impact factor: 5.742
Authors: Michael A Pulsipher; Pintip Chitphakdithai; Brent R Logan; Susan F Leitman; Paolo Anderlini; John P Klein; Mary M Horowitz; John P Miller; Roberta J King; Dennis L Confer Journal: Blood Date: 2009-07-16 Impact factor: 22.113
Authors: Ryotaro Nakamura; Nademanee Auayporn; David D Smith; Joycelynne Palmer; Joel Y Sun; Jeffrey Schriber; Vinod Pullarkat; Pablo Parker; Roberto Rodriguez; Anthony Stein; Joseph Rosenthal; Shirong Wang; Chatchada Karanas; Karl Gaal; David Senitzer; Stephen J Forman Journal: Biol Blood Marrow Transplant Date: 2008-04 Impact factor: 5.742
Authors: Tim Pfeiffer; Michael Schleuning; Jiri Mayer; Karl-Heinz Haude; Johanna Tischer; Stefanie Buchholz; Donald Bunjes; Gesine Bug; Ernst Holler; Ralf G Meyer; Hildegard Greinix; Christof Scheid; Maximilian Christopeit; Susanne Schnittger; Jan Braess; Günter Schlimok; Karsten Spiekermann; Arnold Ganser; Hans-Jochem Kolb; Christoph Schmid Journal: Haematologica Date: 2012-09-14 Impact factor: 9.941
Authors: Hong Xu; Yiming Huang; Paula M Chilton; Lala-Rukh Hussain; Michael K Tanner; Jun Yan; Suzanne T Ildstad Journal: J Immunol Date: 2008-11-01 Impact factor: 5.422