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Comparison of conditioning regimens of various intensities for allogeneic hematopoietic SCT using HLA-identical sibling donors in AML and MDS with <10% BM blasts: a report from EBMT
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Comparison of conditioning regimens of various intensities for allogeneic hematopoietic SCT using HLA-identical sibling donors in AML and MDS with <10% BM blasts: a report from EBMT
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Comparison of conditioning regimens of various intensities for allogeneic hematopoietic SCT using HLA-identical sibling donors in AML and MDS with <10% BM blasts: a report from EBMT
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Journal Article
Comparison of conditioning regimens of various intensities for allogeneic hematopoietic SCT using HLA-identical sibling donors in AML and MDS with <10% BM blasts: a report from EBMT
2013
Overview
In this multicenter retrospective study, the long-term outcomes of 878 adults with AML and refractory anemia with excess blasts (RAEB) with BM blasts <10% who underwent transplantation with an HLA-identical sibling donor between 1998 and 2004 were analyzed according to four regimens of conditioning intensity: reduced-intensity conditioning (RIC) (either intermediate RIC (IntermRIC) or non-myeloablative (NMA) RIC), and myeloablative conditioning (MC) in 718 patients (either conventional MC or hyperintense MC. In multivariate cox analysis, patients undergoing NMA transplantation had lower non-relapse mortality risk in the first 100 days after transplantation (
P
<0.01), but a higher risk beyond day +100 (
P
=0.02), as well as higher relapse incidence in the first 12 months (
P
<0.01), but the risk was similar in all groups beyond 12 months. The probabilities of PFS and OS up to 7 years were significantly lower only in the NMA subgroup (
P
⩽0.01 for both). The 7-year OS was 53%, 29%, 56% and 51%, respectively. Our data suggest that prospective studies comparing RIC regimens (especially IntermRIC) with MC are appropriate in patients with AML and RAEB who are in a non-advanced disease status.
Publisher
Nature Publishing Group UK,Nature Publishing Group
Subject
/ Adult
/ Aged
/ Anemia
/ Anemia, Refractory, with Excess of Blasts - mortality
/ Anemia, Refractory, with Excess of Blasts - therapy
/ Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
/ Biological and medical sciences
/ Bone marrow, stem cells transplantation. Graft versus host reaction
/ Female
/ Hematologic and hematopoietic diseases
/ Hematopoietic Stem Cell Transplantation
/ Histocompatibility antigen HLA
/ Humans
/ Leukemia, Myeloid, Acute - mortality
/ Leukemia, Myeloid, Acute - therapy
/ Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis
/ Male
/ Medicine
/ Risk
/ Siblings
/ Transfusions. Complications. Transfusion reactions. Cell and gene therapy
