Abstract |
Hemopoietic stem cell transplantation (SCT) with fully ablative conditioning is associated with an age-related increase in treatment-related mortality. It is therefore particularly unsuited to older individuals, who are most at risk of developing acute myeloid leukemia (AML). Reduced-intensity SCT (RISCT) may be of value in this group. We report 17 consecutive patients with high-risk AML whose median age was 58 years and who received stem cells from HLA-matched siblings (n=5), or alternative donors (n=12). We used lymphodepleting antibodies as a part of the reduced-intensity conditioning regimen to limit the risk of graft rejection and graft-versus-host disease (GVHD). All patients engrafted. One patient developed severe fatal GVHD, and two patients died of infection. At a median follow-up of 861 days (372-1957 days), seven patients are alive in remission, which includes two patients treated in relapse and five patients who lacked an MHC identical sibling donor. Both progression-free survival and overall survival are 40% (95% CI, 17-64%). Hence, RISCT using lymphodepleting antibodies may be of value for older patients with AML, even in those with active or high-risk disease, and even if they lack an MHC-identical sibling donor.
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Authors | U Popat, H E Heslop, A Durett, R May, R A Krance, M K Brenner, G Carrum |
Journal | Bone marrow transplantation
(Bone Marrow Transplant)
Vol. 37
Issue 6
Pg. 547-52
(Mar 2006)
ISSN: 0268-3369 [Print] England |
PMID | 16462757
(Publication Type: Journal Article)
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Chemical References |
- Antilymphocyte Serum
- Immunosuppressive Agents
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Topics |
- Acute Disease
- Adult
- Aged
- Antilymphocyte Serum
(therapeutic use)
- Female
- Follow-Up Studies
- Graft vs Host Disease
(epidemiology)
- Humans
- Immunosuppressive Agents
(therapeutic use)
- Infections
(epidemiology)
- Leukemia, Myeloid
(therapy)
- Major Histocompatibility Complex
- Male
- Middle Aged
- Stem Cell Transplantation
(adverse effects)
- Time Factors
- Transplantation Chimera
- Transplantation, Homologous
- Treatment Outcome
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