Allogeneic hematopoietic cell transplantation (HCT) following reduced-intensity conditioning in patients with acute leukemias

Niederwieser, Dietger; Gentilini, Chiara; Hegenbart, Ute; Lange, Thoralf; Becker, Cornelia; Wang, Song‐Yau; Bartsch, Kristina; Pönisch, Wolfram; Raida, Martin; Al-Ali, Haifa Kathrin

doi:10.1016/j.critrevonc.2005.03.016

Cited by 12 publications

(6 citation statements)

References 32 publications

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“…In contrast, several recent studies have suggested that TRM may significantly be reduced in older (Ͼ 50 years) patients with AML following allo-SCT and reduced intensity conditioning (RIC). 26,27 Mohty et al 28 recently reported the first donor versus no-donor analysis in older patients with AML, for whom an RIC allo-SCT was intended following the identification of a matched sibling donor. Although the study included only a limited number of patients, improved DFS was suggested for patients with a donor.…”

Section: Discussionmentioning

confidence: 99%

Results of a HOVON/SAKK donor versus no-donor analysis of myeloablative HLA-identical sibling stem cell transplantation in first remission acute myeloid leukemia in young and middle-aged adults: benefits for whom?

Cornelissen

Putten

Verdonck

et al. 2007

Blood

440

342

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The Dutch-Belgian Hemato-Oncology Cooperative Group and the Swiss Group for Clinical Cancer Research (HOVON-SAKK) collaborative study group evaluated outcome of patients (pts) with acute myeloid leukemia (AML) in first remission (CR1) entered in 3 consecutive studies according to a donor versus no-donor comparison. Between 1987 and 2004, 2287 pts were entered in these studies of whom 1032 pts (45%) without FAB M3 or t(15;17) were in CR1 after 2 cycles of chemotherapy, received consolidation treatment, and were younger than 55 years of age and therefore eligible for allogeneic hematopoietic stem cell transplantation (allo-SCT). An HLA-identical sibling donor was available for 326 pts (32%), whereas 599 pts (58%) lacked such a donor, and information was not available in 107 pts. Compliance with allo-SCT was 82% (268 of 326). Cumulative incidences of relapse were, respectively, 32% versus 59% for pts with versus those without a donor (P < .001). Despite more treatmentrelated mortality (TRM) in the donor group (21% versus 4%, P < .001), disease-free survival (DFS) appeared significantly better in the donor group (48% ؎ 3% versus 37% ؎ 2% in the no-donor group, P < .001). Following risk-group analysis, DFS was significantly better for pts with a donor and an intermediate-(P ‫؍‬ .01) or poor-risk profile (P ‫؍‬ .003) and also better in pts younger than 40 years of age (P < .001). We evaluated our results and those of the previous MRC, BGMT, and EORTC studies in a meta-analysis, which revealed a significant benefit of 12% in overall survival (OS) by donor availability for all patients with AML in CR1 without a favorable cytogenetic profile. (Blood.

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Section: Discussionmentioning

confidence: 99%

Results of a HOVON/SAKK donor versus no-donor analysis of myeloablative HLA-identical sibling stem cell transplantation in first remission acute myeloid leukemia in young and middle-aged adults: benefits for whom?

Cornelissen

Putten

Verdonck

et al. 2007

Blood

440

342

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“…Reduced-intensity conditioning (RIC) regimens within the allogeneic setting 12 aim to reduce non-relapse mortality (NRM) without loss of the antitumor activity, relying solely on the GvL effect. [13][14][15] This type of procedure, with the use of related or unrelated donor grafts, can thus be applied to an older patient population, otherwise ineligible for conventional allogeneic transplantation.…”

Section: Introductionmentioning

confidence: 99%

HLA-identical sibling allogeneic peripheral blood stem cell transplantation with reduced intensity conditioning compared to autologous peripheral blood stem cell transplantation for elderly patients with de novo acute myeloid leukemia

et al. 2006

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We conducted a retrospective registry-based analysis to compare the outcome of 361 allogeneic human leukocyte antigen (HLA)-identical peripheral blood stem cell transplants (PBSCT) with reduced intensity conditioning (RIC) to that of 1369 autologous (auto) PBSCT in patients aged 50 years or older with de novo acute myeloid leukemia (AML), performed from 1997 until 2003 and reported to the European Group for Blood and Marrow Transplantation. Median age was 58 and 57 years in the RIC and auto groups, respectively. RIC patients had more advanced disease at the time of transplant. At a median follow-up of 24 months for RIC and 16 months for auto, multivariate analysis showed a lower risk for relapse (RR 0.77, P ¼ 0.013) without increased non-relapse mortality (NRM) in RIC patients (RR 1.26, P ¼ 0.28). Moreover, leukemia-free survival (RR 1.22, P ¼ 0.02) and overall survival (OS) (RR 1.32, P ¼ 0.005) were superior in the RIC group. In patients in 1st (CR), fewer relapses were counterbalanced by significantly increased NRM. Therefore, there was no survival advantage in this subgroup. In patients in 2nd or subsequent CR, LFS and OS were superior in the RIC group. RIC transplants show encouraging results in this older patient population with de novo AML.

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“…Six patients with AML had relapsed/refractory disease at the time of transplant. This was clearly a major determining factor in our outcome as patients with AML in CR1 have markedly better overall and progression free survival than those beyond CR1 after NST (15)(16)(17)(18). Relapse rate for patients with NHL was 29% and 33% for those with MM.…”

Section: Discussionmentioning

confidence: 96%

Graft Versus Host Disease After Stem Cell Allotransplantation With Low-Dose Total Body Irradiation, Fludarabine, and Antithymocyte Globulin

et al. 2007

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Allogeneic hematopoietic cell transplantation (HCT) following reduced-intensity conditioning in patients with acute leukemias

Cited by 12 publications

References 32 publications

Results of a HOVON/SAKK donor versus no-donor analysis of myeloablative HLA-identical sibling stem cell transplantation in first remission acute myeloid leukemia in young and middle-aged adults: benefits for whom?

Results of a HOVON/SAKK donor versus no-donor analysis of myeloablative HLA-identical sibling stem cell transplantation in first remission acute myeloid leukemia in young and middle-aged adults: benefits for whom?

HLA-identical sibling allogeneic peripheral blood stem cell transplantation with reduced intensity conditioning compared to autologous peripheral blood stem cell transplantation for elderly patients with de novo acute myeloid leukemia

Graft Versus Host Disease After Stem Cell Allotransplantation With Low-Dose Total Body Irradiation, Fludarabine, and Antithymocyte Globulin

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