A prospective multicenter trial of peripheral blood stem cell sibling allografts for acute myeloid leukemia in first complete remission using fludarabine-cyclophosphamide reduced intensity conditioning

Grigg, A. P., Gibson, J., Bardy, P. G., Reynolds, J., Shuttleworth, P., Koelmeyer, R. L., Szer, J., Roberts, A. W., To, L. B., Kennedy, G. and Bradstock, K. F. (2007) A prospective multicenter trial of peripheral blood stem cell sibling allografts for acute myeloid leukemia in first complete remission using fludarabine-cyclophosphamide reduced intensity conditioning. Biology of Blood and Marrow Transplantation, 13 5: 560-567. doi:10.1016/j.bbmt.2006.12.449


Author Grigg, A. P.
Gibson, J.
Bardy, P. G.
Reynolds, J.
Shuttleworth, P.
Koelmeyer, R. L.
Szer, J.
Roberts, A. W.
To, L. B.
Kennedy, G.
Bradstock, K. F.
Title A prospective multicenter trial of peripheral blood stem cell sibling allografts for acute myeloid leukemia in first complete remission using fludarabine-cyclophosphamide reduced intensity conditioning
Journal name Biology of Blood and Marrow Transplantation   Check publisher's open access policy
ISSN 1083-8791
1523-6536
Publication date 2007-05
Year available 2007
Sub-type Article (original research)
DOI 10.1016/j.bbmt.2006.12.449
Volume 13
Issue 5
Start page 560
End page 567
Total pages 8
Place of publication Philadelphia, United States
Publisher Elsevier
Language eng
Formatted abstract
The role of allogeneic transplantation in patients with de novo acute myeloid leukemia in first complete remission (AML-CR1) is controversial. Aiming to preserve a graft-versus-leukemia effect, but minimize morbidity and mortality from conditioning-related toxicity and graft-versus-host disease (GVHD), we conducted a prospective multicenter study of reduced-intensity conditioning (RIC) as preparation for peripheral blood stem cell sibling allografts in patients with intermediate or poor risk AML-CR1. Conditioning consisted of fludarabine 125 mg/m 2 and cyclophosphamide 120 mg/kg. Thirty-four patients were transplanted with a median age of 45 years; 85% had intermediate risk cytogenetics. Early toxicity was minimal. The overall incidence of grade II-IV acute GVHD was low (21%), but the 3 patients (9%) who developed grade IV GVHD died. Donor T cell chimerism was rapid and generally complete, but complete myeloid chimerism was delayed. Thirteen patients (38%) relapsed, 12 within a year of transplant. The estimated disease-free survival (DFS) and overall survival at 2 years was 56% (95% confidence interval [CI] 39%-71%) and 68% (95% CI 50%-81%), respectively. The incidence of extensive chronic GVHD (cGVHD) was low (24% of surviving patients at 12 months) and most survivors had an excellent performance status. These observations justify a prospective comparison of RIC versus myeloablative conditioning allografts for AML-CR1.
Keyword Aml
remission
reduced intensity conditioning
Versus-Host-Disease
Bone-Marrow Transplantation
Acute Myeloblastic-Leukemia
Total-Body Irradiation
Myelodysplastic Syndrome
Postremission Therapy
Current Controversies
Working Party
Regimen
Risk
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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