Reduced-intensity conditioned allogeneic haematopoietic stem cell transplantation results in durable disease-free and overall survival in patients with poor prognosis myeloid and lymphoid malignancies: eighty-month follow-up

Patil, Sushrut; Spencer, Andrew; Schwarer, Anthony P.; Lewis, Ian D.; Hertzberg, Mark; Avery, Sharon; Wei, Andrew H.; Noutsos, Tina; Paul, Eldho; Taouk, Yamna; Muirhead, Jenny

doi:10.1038/bmt.2009.322

Cited by 4 publications

(5 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…RIC regimens have been proposed to produce equivalent or superior survival rates when compared to myeloablative regimens in subjects with myeloid and lymphoid cancers (13–15), yet published literature on outcomes of RIC regimens for NHL are limited to relatively small series. PFS is reported to range from 22–59% at three years after HCT, with the best outcomes observed for indolent histologies.…”

Section: Discussionmentioning

confidence: 99%

“…Although 43% of subjects were alive in remission at one year after HCT, only 26% were free of disease progression at five years post HCT. Single institution studies reporting higher PFS rates generally included smaller patient numbers and subjects with closer HLA matching to donors, or included predominately low-risk NHL such as those with indolent lymphoma or in remission (15–18). The low PFS in our cohort likely results from the high-risk disease, extensive prior therapy, older median age of this patient population, and the high graft failure and TRM rates.…”

Section: Discussionmentioning

confidence: 99%

“…Alternatively, the effect may have been abrogated due to the high rates of graft failure or TRM. A graft-versus-lymphoma effect has not been consistently correlated with GVHD after allogeneic HCT, suggesting that it may operate independently of GVHD (15,20). …”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Alternate Donor Hematopoietic Cell Transplantation (HCT) in Non-Hodgkin Lymphoma Using Lower Intensity Conditioning: A Report from the CIBMTR

Hale

Shrestha

Le‐Rademacher

et al. 2012

Biology of Blood and Marrow Transplantation

View full text Add to dashboard Cite

We analyzed the outcomes of 248 (61% male) adult recipients of HLA-matched unrelated and HLA-mismatched related donor hematopoietic cell transplantation (HCT) for non-Hodgkin lymphoma (NHL) after reduced or lower intensity conditioning (RIC), reported to the Center for International Blood and Marrow Transplant Research (CIBMTR) from 1997 to 2004. Median age was 52 (range, 18–72 yrs); 31% had a Karnofsky performance score <90. Follicular NHL (43%) was the major histology. Incidence of grades II–IV acute graft-versus-host disease (GVHD) was 43% at 100 days; and chronic GVHD was 44% at three years. Treatment-related mortality (TRM) at 100 days was 24%. Three-year overall survival (OS) and progression-free survival (PFS) were 41% and 32%, respectively. In multivariate analysis, use of anti-thymocyte globulin (ATG) and HLA mismatch were associated with increased TRM. High-grade histology, ATG use and chemotherapy resistance were associated with lower progression-free survival (PFS). Older age, shorter interval from diagnosis to HCT, non-TBI conditioning regimens, ex vivo T-cell depletion and HLA-mismatched unrelated donors were associated with mortality. GVHD did not influence relapse or PFS. Older age, aggressive histology and chemotherapy resistance correlated with poorer survival. For selected patients with NHL, lack of an available sibling donor should not be a barrier to allogeneic HCT.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Alternate Donor Hematopoietic Cell Transplantation (HCT) in Non-Hodgkin Lymphoma Using Lower Intensity Conditioning: A Report from the CIBMTR

Hale

Shrestha

Le‐Rademacher

et al. 2012

Biology of Blood and Marrow Transplantation

View full text Add to dashboard Cite

show abstract

“…The most frequently used treatment protocol (fludarabine and busulfan) was a reduced intensity conditioning regimen. This strategy is widely used because it exerts considerably less toxic effects than conventional conditioning regimens, permits older patients and patients with comorbidities to undergo HSCT, and reduces morbidity and mortality related to the procedure (Mackall et al 2009, Patil et al 2009).…”

Section: Discussionmentioning

confidence: 99%

Cyclosporine level: difference between blood samples collected through peripheral and central venous access

Garbin

Tonani²,

Salvador³

et al. 2012

Journal of Clinical Nursing

View full text Add to dashboard Cite

show abstract

“…Patil and co-workers reported the outcome of 79 poor-risk hematological malignancy patients from three Australian centres, who were, treated using RIC followed by alloHPCT [64]. The majority of the patients had AML/ myelodysplasia (n=43), or non Hodgkin lymphoma (n=30).…”

Section: Reduced Intensity Conditioningmentioning

confidence: 97%

Redefining Transplant in Acute Leukemia

Sellar

Goldstone

Lazarus

2011

Curr. Treat. Options in Oncol.

View full text Add to dashboard Cite

Assigning the correct treatment to those with acute leukemia is challenging and requires careful assessment of both the disease and the patient. Our ability to assign relapse risk to disease is evolving and incorporates cytogenetics, molecular lesions, and assessment of minimal residual disease after initial treatment. Allogeneic hematopoietic progenitor cell transplantation (alloHCPT) is one of the most efficacious treatments available to the physician. In adult acute lymphoblastic leukemia (ALL) despite the treatment risk, patients with a matched sibling who achieve CR should be referred for transplant. Prospective trials investigating the role of unrelated donors are in progress. There is little prospective evidence, but nonetheless encouraging data, to support referring older patients for alloHPCT using reduced intensity conditioning (RIC) regimens. In acute myeloid leukemia (AML), all high-risk patients and the majority of intermediate-risk patients with a matched sibling should be offered alloHPCT in CR1. In addition there is evidence that some patients previously assigned as good-risk would benefit from sibling transplant. Use of unrelated donors will expand the numbers eligible for transplant and should be considered when a matched-sibling is not available particularly in high-risk patients. Similarly to ALL, the use of RIC is allowing transplantation to be offered to those deemed too old or unfit for myeloablative conditioning. The importance of enrolling patients into suitable prospective clinical trials cannot be overstated.

show abstract

Reduced-intensity conditioned allogeneic haematopoietic stem cell transplantation results in durable disease-free and overall survival in patients with poor prognosis myeloid and lymphoid malignancies: eighty-month follow-up

Cited by 4 publications

References 31 publications

Alternate Donor Hematopoietic Cell Transplantation (HCT) in Non-Hodgkin Lymphoma Using Lower Intensity Conditioning: A Report from the CIBMTR

Alternate Donor Hematopoietic Cell Transplantation (HCT) in Non-Hodgkin Lymphoma Using Lower Intensity Conditioning: A Report from the CIBMTR

Cyclosporine level: difference between blood samples collected through peripheral and central venous access

Redefining Transplant in Acute Leukemia

Contact Info

Product

Resources

About