Comparison of reduced-intensity conditioning regimens in patients with acute lymphoblastic leukemia > 45 years undergoing allogeneic stem cell transplantation-a retrospective study by the Acute Leukemia Working Party of EBMT
| Autor: | Ben Carpenter, Montserrat Rovira, Jürgen Kuball, Arnon Nagler, Mohamad Mohty, Sebastian Giebel, Harry C. Schouten, Gérard Socié, Maria H. Gilleece, Myriam Labopin, Jenny Byrne, Zinaida Peric, Ram Malladi, Michael Potter, Christophe Peczynski, Jan J. Cornelissen, Emmanuelle Polge, Nathalie Fegueux |
|---|---|
| Přispěvatelé: | RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, MUMC+: MA Hematologie (9), Interne Geneeskunde, Hematology |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
1st complete remission medicine.medical_treatment RELAPSE RISK MINIMAL RESIDUAL DISEASE adult patients Hematopoietic stem cell transplantation PERIPHERAL-BLOOD EUROPEAN-GROUP versus-host-disease Internal medicine medicine Cumulative incidence free survival Transplantation Acute leukemia bone-marrow ph plus business.industry Hematology Minimal residual disease Fludarabine Regimen business Busulfan medicine.drug |
| Zdroj: | Bone Marrow Transplantation, 55(8), 1560-1569. Nature Publishing Group |
| ISSN: | 1476-5365 0268-3369 |
| Popis: | The optimal reduced-intensity conditioning (RIC) for patients with acute lymphoblastic leukemia (ALL) undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains unclear. We retrospectively analyzed 417 patients > 45 years with ALL in first complete remission who underwent a matched sibling or unrelated allo-HSCT and compared outcomes between fludarabine/busulfan (FLUBU, n = 127), fludarabine/melphalan (FLUMEL, n = 190), and fludarabine-TBI (FLUTBI, n = 100) conditioning. At 2 years, there were no differences between the groups in terms of cumulative incidence (CI) of relapse (40% for FLUBU vs 36% for FLUMEL vs 41% for FLUTBI, p = 0.21); transplant-related mortality (TRM) (18% for FLUBU, 22% for FLUMEL, 14% for FLUTBI, p = 0.09); overall survival (55% for FLUBU, 50% for FLUMEL, 60% for FLUTBI, p = 0.62) or leukemia-free survival (43% for FLUBU, 42% for FLUMEL, 45% for FLUTBI, p = 0.99), but GVHD-relapse-free survival was significantly lower in the FLUTBI group than FLUBU and FLUMEL group (18% vs 35% vs 28%, p = 0.02). However, this difference was lost in the multivariate analysis when adjusted for the in vivo T-cell depletion. Finally, the FLUMEL regimen was shown to be an independent risk factor for a higher TRM (HR 1.97, 95% CI 1.05-3.72, p = 0.04). We conclude that the three most popular RIC regimens yield similar transplant outcomes. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink