PURPOSE: Reduced intensity conditioning regimen (RIC) is increasingly used in hematopoietic stem cell transplantation (HSCT). Unrelated donor (UD) transplants have more complications. We wanted to examine if RIC is a valid treatment option using UD in acute myeloblastic leukemia (AML). PATIENTS AND METHODS: Between 1999 and 2005, 401 patients with AML were treated with RIC and 1,154 received myeloablative conditioning (MAC), using UD and reported to the European Group for Blood and Marrow Transplantation Registry. Patients < and > or = 50 years of age were analyzed separately. RESULTS: Patients receiving RIC were older, received transplants more recently, received peripheral blood stem cells more frequently, and were treated with total-body irradiation less often. In multivariable analysis, in patients younger than 50 years of age, nonrelapse mortality (NRM) was similar using RIC (hazard ratio [HR], 0.85; P = .41), relapse was increased (HR, 1.46; P = .02) and leukemia-free survival (LFS) was the same (HR, 0.88; P = .28), as compared with MAC. In patients > or = 50 years of age, NRM was decreased in the RIC group (HR, 0.64; P = .04), relapse probability was not significantly different (HR, 1.34; P = .16) and LFS was similar (HR, 1.04; P = .79) compared with MAC. CONCLUSION RIC-UD transplants are associated with higher relapse in AML patients younger than 50 years of age and decreased NRM in those > or = 50 years compared with MAC-UD. LFS was similar after both conditioning regimens, regardless of age. Therefore, RIC-UD extend the use of allotransplants for elderly patients and strategies that decrease relapse should be considered mainly in younger patients with AML.
PURPOSE: Reduced intensity conditioning regimen (RIC) is increasingly used in hematopoietic stem cell transplantation (HSCT). Unrelated donor (UD) transplants have more complications. We wanted to examine if RIC is a valid treatment option using UD in acute myeloblastic leukemia (AML). PATIENTS AND METHODS: Between 1999 and 2005, 401 patients with AML were treated with RIC and 1,154 received myeloablative conditioning (MAC), using UD and reported to the European Group for Blood and Marrow Transplantation Registry. Patients < and > or = 50 years of age were analyzed separately. RESULTS:Patients receiving RIC were older, received transplants more recently, received peripheral blood stem cells more frequently, and were treated with total-body irradiation less often. In multivariable analysis, in patients younger than 50 years of age, nonrelapse mortality (NRM) was similar using RIC (hazard ratio [HR], 0.85; P = .41), relapse was increased (HR, 1.46; P = .02) and leukemia-free survival (LFS) was the same (HR, 0.88; P = .28), as compared with MAC. In patients > or = 50 years of age, NRM was decreased in the RIC group (HR, 0.64; P = .04), relapse probability was not significantly different (HR, 1.34; P = .16) and LFS was similar (HR, 1.04; P = .79) compared with MAC. CONCLUSION RIC-UD transplants are associated with higher relapse in AMLpatients younger than 50 years of age and decreased NRM in those > or = 50 years compared with MAC-UD. LFS was similar after both conditioning regimens, regardless of age. Therefore, RIC-UD extend the use of allotransplants for elderly patients and strategies that decrease relapse should be considered mainly in younger patients with AML.
Authors: H Nahi; M Remberger; M Machaczka; J Ungerstedt; J Mattson; O Ringden; Katarina Le-Blanc; P Ljungman; H Hägglund Journal: Med Oncol Date: 2012-01-11 Impact factor: 3.064
Authors: Junya Kanda; David A Rizzieri; Cristina Gasparetto; Gwynn D Long; John P Chute; Keith M Sullivan; Ashley Morris; Clayton A Smith; Donna E Hogge; Janet Nitta; Kevin Song; Donna Niedzwiecki; Nelson J Chao; Mitchell E Horwitz Journal: Biol Blood Marrow Transplant Date: 2010-09-22 Impact factor: 5.742
Authors: Saurabh Chhabra; Kwang Woo Ahn; Zhen-Huan Hu; Sandeep Jain; Amer Assal; Jan Cerny; Edward A Copelan; Andrew Daly; Zachariah DeFilipp; Shahinaz M Gadalla; Robert Peter Gale; Siddhartha Ganguly; Betty K Hamilton; Gerhard Carl Hildebrandt; Jack W Hsu; Yoshihiro Inamoto; Abraham S Kanate; H Jean Khoury; Hillard M Lazarus; Mark R Litzow; Sunita Nathan; Richard F Olsson; Attaphol Pawarode; Olle Ringden; Jacob M Rowe; Ayman Saad; Bipin N Savani; Harry C Schouten; Sachiko Seo; Nirav N Shah; Melhem Solh; Robert K Stuart; Celalettin Ustun; Ann E Woolfrey; Jean A Yared; Edwin P Alyea; Matt E Kalaycio; Uday Popat; Ronald M Sobecks; Wael Saber Journal: Blood Adv Date: 2018-11-13
Authors: Menachem Bitan; Wensheng He; Mei-Jie Zhang; Hisham Abdel-Azim; Mouhab Fakhreddine Ayas; Bella Bielorai; Paul A Carpenter; Mitchell S Cairo; Miguel Angel Diaz; John T Horan; Sonata Jodele; Carrie L Kitko; Kirk R Schultz; Morris Kletzel; Kimberly A Kasow; Leslie E Lehmann; Parinda A Mehta; Nirali Shah; Michael A Pulsipher; Tim Prestidge; Adriana Seber; Shalini Shenoy; Ann E Woolfrey; Lolie C Yu; Stella M Davies Journal: Blood Date: 2014-01-16 Impact factor: 22.113