Abstract |
We analyzed outcomes of patients with myelodysplastic syndrome (MDS) or secondary acute myelogenous leukemia (sAML) that were treated at our institution with a reduced intensity conditioning (RIC) regimen of 550-cGy total body irradiation and cyclophosphamide followed by related donor (RD) or unrelated donor (URD) transplantation. Fifty-one consecutive patients with MDS or sAML received this RIC regimen and URD ( n = 30) or RD (n = 21) stem cells. Graft-versus-host disease prophylaxis consisted of cyclosporine alone (RD) or with corticosteroids and methotrexate (URD). Median patient age was 44 years. With a median follow-up of 3.7 years after transplantation in the 19 surviving patients (37%), Kaplan-Meier estimates of overall survival were 88%, 46%, 33%, and 11% for patients transplanted with sAML in remission, refractory anemia, refractory anemia with excess blasts, refractory anemia with excess blasts in transformation, or sAML refractory/untreated, respectively. Kaplan-Meier estimates of relapse-free survival were 75%, 46%, 33%, and 11%, respectively. Overall, the cumulative incidences of relapse and transplant-related mortality were 27% and 37%, respectively. In patients with MDS, this is an effective RIC regimen for allogeneic transplantation that can be used as an alternative to other RIC or conventional conditioning regimens.
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Authors | Christopher L Hallemeier, Mark D Girgis, William G Blum, Randy A Brown, Hanna J Khoury, Steven M Devine, Ravi Vij, Hsu-san Lin, John F DiPersio, Douglas R Adkins |
Journal | Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
(Biol Blood Marrow Transplant)
Vol. 12
Issue 7
Pg. 749-57
(Jul 2006)
ISSN: 1083-8791 [Print] United States |
PMID | 16785064
(Publication Type: Journal Article)
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Chemical References |
- Myeloablative Agonists
- Cyclophosphamide
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Topics |
- Adult
- Aged
- Analysis of Variance
- Bone Marrow Transplantation
(methods, mortality)
- Cyclophosphamide
(therapeutic use)
- Female
- Graft Survival
- Graft vs Host Disease
(etiology)
- Humans
- Leukemia, Myeloid, Acute
(therapy)
- Male
- Middle Aged
- Myeloablative Agonists
(therapeutic use)
- Myelodysplastic Syndromes
(therapy)
- Neoplasms, Second Primary
(therapy)
- Peripheral Blood Stem Cell Transplantation
(methods, mortality)
- Radiotherapy Dosage
- Recurrence
- Retrospective Studies
- Survival Analysis
- Transplantation Conditioning
(methods)
- Whole-Body Irradiation
(methods)
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