Fludarabine Melphalan reduced-intensity conditioning allotransplanation provides similar disease control in lymphoid and myeloid malignancies: analysis of 344 patients

Bryant, A., Nivison-Smith, I., Pillai, E. S., Kennedy, G., Kalff, A., Ritchie, D., George, B., Hertzberg, M., Patil, S., Spencer, A., Fay, K., Cannell, P., Berkahn, L., Doocey, R., Spearing, R. and Moore, J. (2014) Fludarabine Melphalan reduced-intensity conditioning allotransplanation provides similar disease control in lymphoid and myeloid malignancies: analysis of 344 patients. Bone Marrow Transplantation, 49 1: 17-23. doi:10.1038/bmt.2013.142


Author Bryant, A.
Nivison-Smith, I.
Pillai, E. S.
Kennedy, G.
Kalff, A.
Ritchie, D.
George, B.
Hertzberg, M.
Patil, S.
Spencer, A.
Fay, K.
Cannell, P.
Berkahn, L.
Doocey, R.
Spearing, R.
Moore, J.
Title Fludarabine Melphalan reduced-intensity conditioning allotransplanation provides similar disease control in lymphoid and myeloid malignancies: analysis of 344 patients
Journal name Bone Marrow Transplantation   Check publisher's open access policy
ISSN 0268-3369
1476-5365
Publication date 2014
Year available 2013
Sub-type Article (original research)
DOI 10.1038/bmt.2013.142
Open Access Status
Volume 49
Issue 1
Start page 17
End page 23
Total pages 7
Place of publication London, United Kingdom
Publisher Nature Publishing
Collection year 2014
Language eng
Abstract This was an Australasian Bone Marrow Transplant Recipient Registry (ABMTRR)-based retrospective study assessing the outcome of Fludarabine Melphalan (FluMel) reduced-intensity conditioning between 1998 and 2008. Median follow-up was 3.4 years. There were 344 patients with a median age of 54 years (18-68). In all, 234 patients had myeloid malignancies, with AML (n=166) being the commonest indication. There were 110 lymphoid patients with non-hodgkins lymphoma (NHL) (n=64) the main indication. TRM at day 100 was 14% with no significant difference between the groups. OS and disease-free survival (DFS) were similar between myeloid and lymphoid patients (57 and 50% at 3 years, respectively). There was no difference in cumulative incidence of relapse or GVHD between groups. Multivariate analysis revealed four significant adverse risk factors for DFS: donor other than HLA-identical sibling donor, not in remission at transplant, previous autologous transplant and recipient CMV positive. Chronic GVHD was associated with improved DFS in multivariate analysis predominantly due to a marked reduction in relapse (HR:0.44, P=0.003). This study confirms that FluMel provides durable and equivalent remissions in both myeloid and lymphoid malignancies. Disease stage and chronic GVHD remain important determinants of outcome for FluMel allografting.
Keyword Haematology
Leukaemia
Lymphoma
Reduced-intensity conditioning
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Non HERDC
School of Medicine Publications
 
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