Reduced intensity conditioning regimens including alkylating chemotherapy do not alter survival outcomes after allogeneic hematopoietic cell transplantation in chronic lymphocytic leukemia compared to low-intensity non-myeloablative conditioning

Autor: Andersen, N.S., Bornhauser, M., Gramatzki, M., Dreger, P., Vitek, A., Karas, M., Michallet, M., Moreno, C., Gelder, M. van, Henseler, A., Wreede, L.C. de, Schonland, S., Kroger, N., Schetelig, J., CLL subcomm Chronic
Přispěvatelé: Interne Geneeskunde, MUMC+: MA Hematologie (9), RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy
Jazyk: angličtina
Rok vydání: 2019
Předmět:
0301 basic medicine
Oncology
Male
Cancer Research
Transplantation Conditioning
BLOOD
medicine.medical_treatment
Chronic lymphocytic leukemia
Graft vs Host Disease
refractory chronic lymphocytic leukemia
Hematopoietic stem cell transplantation
RETROSPECTIVE ANALYSIS
0302 clinical medicine
hemic and lymphatic diseases
TOTAL-BODY IRRADIATION
Antineoplastic Combined Chemotherapy Protocols
LYMPHOMA
Medicine
FAILURE
Nonmyeloablative
Melphalan
Hematology
Incidence
Remission Induction
Hematopoietic Stem Cell Transplantation
General Medicine
Middle Aged
Prognosis
Combined Modality Therapy
EUROPEAN-SOCIETY
Survival Rate
030220 oncology & carcinogenesis
Reduced Intensity Conditioning
Allogeneic hematopoietic stem cell transplantation
Female
FLUDARABINE
Adult
medicine.medical_specialty
Relapsed
03 medical and health sciences
Young Adult
reduced intensity conditioning
Internal medicine
Humans
Transplantation
Homologous
MARROW-TRANSPLANTATION
Busulfan
Cyclophosphamide
Aged
Retrospective Studies
Chemotherapy
business.industry
medicine.disease
Leukemia
Lymphocytic
Chronic
B-Cell
Intensity (physics)
Transplantation
030104 developmental biology
Conditioning
business
FOLLOW-UP
CLL
Follow-Up Studies
Zdroj: Journal of Cancer Research and Clinical Oncology, 145(11), 2823-2834. Springer, Cham
JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY
r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname
Journal of Cancer Research and Clinical Oncology, 145(11), 2823-2834
ISSN: 0171-5216
Popis: Purpose The optimal dose intensity for conditioning prior to allogeneic hematopoietic stem cell transplantation (alloHSCT) for chronic lymphocytic leukemia (CLL) is unknown. Methods We retrospectively compared outcomes of patients who received a first alloHCST after non-myeloablative (NMA) and reduced intensity conditioning (RIC). Data of 432 patients with a median age of 55 years were included, of which 86 patients underwent NMA and 346 RIC. Results The median follow-up after alloHSCT was 4.3 years. Compared to the RIC group, more NMA patients had purine-analog-sensitive disease, were in complete remission and received matched related donor transplantation. After RIC, the probabilities for 5-year OS, EFS, CIR, and NRM were 46%, 38%, 28%, and 35% and after NMA the respective probabilities were 52%, 43%, 25%, and 32%. In multivariate analysis, remission status prior to conditioning but not RIC versus NMA conditioning had a significant impact on CIR, EFS, and OS. Conclusion Presumed higher anti-leukemic activity of RIC versus NMA conditioning did not translate into better outcomes after alloHSCT, but better remission status prior to conditioning did. Effective pathway inhibitor-based salvage therapies combined with NMA conditioning might thus represent the most attractive contemporary approach for alloHSCT for patients with CLL.
Databáze: OpenAIRE
Externí odkaz: