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Reduced-intensity transplantation for patients with myelodysplastic syndrome achieves durable remission with less graft-versus-host disease.
Biol Blood Marrow Transplant. 2003 Dec; 9(12):753-9.BB

Abstract

Reduced-intensity allogeneic transplantations for myelodysplastic syndrome (MDS) patients have been limited by significant graft-versus-host disease (GVHD), treatment-related mortality, and disease relapse. We treated 18 MDS patients ineligible for standard allogeneic transplantation with a preparative regimen of photopheresis day -7 and -6, pentostatin 4 mg/m(2) by continuous infusion day -5 and -4, and total body irradiation 600 cGy in 3 fractions day -3 and -2, followed by allogeneic stem cell infusion from 6/6 or 5/6 HLA-matched related donors or 6/6 HLA-matched unrelated donors. GVHD prophylaxis consisted of cyclosporin A and a short course of methotrexate. The median age was 54 years (range, 30-70 years). Diagnoses included refractory anemia (n = 2), refractory anemia with ringed sideroblasts (n = 2), refractory anemia with excess blasts (n = 10), refractory anemia with excess blasts in transformation (n = 3), and chronic myelomonocytic leukemia (n = 1). Sixteen of 18 patients developed full donor chimerism with no day +100 transplant-related mortality. Grade II to IV acute GVHD and extensive chronic GVHD developed in 19% and 18% of patients, respectively. Disease relapse occurred in 2 patients. At a median follow-up of 14 months (range, 1-35 months), the 1-year failure-free and overall survival were 64% and 65%, respectively. Our photopheresis and pentostatin-based reduced-intensity preparative regimen for allogeneic bone marrow transplantation in high-risk MDS patients achieves successful donor engraftment and disease remission with less transplant toxicity and grade II to IV acute GVHD.

Authors+Show Affiliations

Department of Medicine, Tufts-New England Medical Center, Boston, Massachusetts 02111, USA. gchan@tufts-nemc.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

14677114

Citation

Chan, Geoffrey W., et al. "Reduced-intensity Transplantation for Patients With Myelodysplastic Syndrome Achieves Durable Remission With Less Graft-versus-host Disease." Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation, vol. 9, no. 12, 2003, pp. 753-9.
Chan GW, Foss FM, Klein AK, et al. Reduced-intensity transplantation for patients with myelodysplastic syndrome achieves durable remission with less graft-versus-host disease. Biol Blood Marrow Transplant. 2003;9(12):753-9.
Chan, G. W., Foss, F. M., Klein, A. K., Sprague, K., & Miller, K. B. (2003). Reduced-intensity transplantation for patients with myelodysplastic syndrome achieves durable remission with less graft-versus-host disease. Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation, 9(12), 753-9.
Chan GW, et al. Reduced-intensity Transplantation for Patients With Myelodysplastic Syndrome Achieves Durable Remission With Less Graft-versus-host Disease. Biol Blood Marrow Transplant. 2003;9(12):753-9. PubMed PMID: 14677114.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reduced-intensity transplantation for patients with myelodysplastic syndrome achieves durable remission with less graft-versus-host disease. AU - Chan,Geoffrey W, AU - Foss,Francine M, AU - Klein,Andreas K, AU - Sprague,Kellie, AU - Miller,Kenneth B, PY - 2003/12/17/pubmed PY - 2004/9/10/medline PY - 2003/12/17/entrez SP - 753 EP - 9 JF - Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation JO - Biol Blood Marrow Transplant VL - 9 IS - 12 N2 - Reduced-intensity allogeneic transplantations for myelodysplastic syndrome (MDS) patients have been limited by significant graft-versus-host disease (GVHD), treatment-related mortality, and disease relapse. We treated 18 MDS patients ineligible for standard allogeneic transplantation with a preparative regimen of photopheresis day -7 and -6, pentostatin 4 mg/m(2) by continuous infusion day -5 and -4, and total body irradiation 600 cGy in 3 fractions day -3 and -2, followed by allogeneic stem cell infusion from 6/6 or 5/6 HLA-matched related donors or 6/6 HLA-matched unrelated donors. GVHD prophylaxis consisted of cyclosporin A and a short course of methotrexate. The median age was 54 years (range, 30-70 years). Diagnoses included refractory anemia (n = 2), refractory anemia with ringed sideroblasts (n = 2), refractory anemia with excess blasts (n = 10), refractory anemia with excess blasts in transformation (n = 3), and chronic myelomonocytic leukemia (n = 1). Sixteen of 18 patients developed full donor chimerism with no day +100 transplant-related mortality. Grade II to IV acute GVHD and extensive chronic GVHD developed in 19% and 18% of patients, respectively. Disease relapse occurred in 2 patients. At a median follow-up of 14 months (range, 1-35 months), the 1-year failure-free and overall survival were 64% and 65%, respectively. Our photopheresis and pentostatin-based reduced-intensity preparative regimen for allogeneic bone marrow transplantation in high-risk MDS patients achieves successful donor engraftment and disease remission with less transplant toxicity and grade II to IV acute GVHD. SN - 1083-8791 UR - https://www.unboundmedicine.com/medline/citation/14677114/Reduced_intensity_transplantation_for_patients_with_myelodysplastic_syndrome_achieves_durable_remission_with_less_graft_versus_host_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1083879103002908 DB - PRIME DP - Unbound Medicine ER -