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Reduced-intensity stem cell transplantation from an HLA-identical sibling donor in patients with myeloid malignancies.
Bone Marrow Transplant. 2004 May; 33(9):891-900.BM

Abstract

The purpose of this study was to evaluate the feasibility and efficacy of allogeneic hematopoietic stem cell transplantation with a reduced-intensity regimen (RIST) in patients with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS). In all, 36 patients (median age 55 years) underwent RIST from an HLA-matched related donor between September 1999 and December 2002. The diagnoses included AML (n=14), leukemia evolving from MDS (n=10), and MDS (refractory anemia with excess blasts n=6, refractory anemia n=6). The RIST regimen consisted of purine analog (cladribine or fludarabine)/busulfan, with or without antithymocyte globulin. The regimen was well tolerated, and 34 patients achieved durable engraftment and most achieved remission after RIST. A total of 17 patients developed grade II-IV acute GVHD, and 27 developed chronic GVHD. Eight patients relapsed, and five of them received antithymocyte globulin (ATG) as part of the preparative regimen. A total of 12 patients died (four disease progression, six transplantation-related complications, and two others). Estimated 1-year disease-free survival (DFS) in low- and high-risk groups was 85 and 64%, respectively. We conclude that RIST can be performed safely in elderly patients with myeloid malignancies, and has therapeutic potential for those who fail conventional chemotherapy. In view of the significant association between GVHD or ATG and DFS, defined management of GVHD following RIST should become a major target of clinical research.

Authors+Show Affiliations

Hematopoietic Stem Cell Transplant Unit, National Cancer Center Hospital, Tokyo, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

15048142

Citation

Hamaki, T, et al. "Reduced-intensity Stem Cell Transplantation From an HLA-identical Sibling Donor in Patients With Myeloid Malignancies." Bone Marrow Transplantation, vol. 33, no. 9, 2004, pp. 891-900.
Hamaki T, Kami M, Kim SW, et al. Reduced-intensity stem cell transplantation from an HLA-identical sibling donor in patients with myeloid malignancies. Bone Marrow Transplant. 2004;33(9):891-900.
Hamaki, T., Kami, M., Kim, S. W., Onishi, Y., Kishi, Y., Murashige, N., Hori, A., Kojima, R., Sakiyama, M., Imataki, O., Heike, Y., Tanosaki, R., Masuo, S., Miyakoshi, S., Taniguchi, S., Tobinai, K., & Takaue, Y. (2004). Reduced-intensity stem cell transplantation from an HLA-identical sibling donor in patients with myeloid malignancies. Bone Marrow Transplantation, 33(9), 891-900.
Hamaki T, et al. Reduced-intensity Stem Cell Transplantation From an HLA-identical Sibling Donor in Patients With Myeloid Malignancies. Bone Marrow Transplant. 2004;33(9):891-900. PubMed PMID: 15048142.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reduced-intensity stem cell transplantation from an HLA-identical sibling donor in patients with myeloid malignancies. AU - Hamaki,T, AU - Kami,M, AU - Kim,S-W, AU - Onishi,Y, AU - Kishi,Y, AU - Murashige,N, AU - Hori,A, AU - Kojima,R, AU - Sakiyama,M, AU - Imataki,O, AU - Heike,Y, AU - Tanosaki,R, AU - Masuo,S, AU - Miyakoshi,S, AU - Taniguchi,S, AU - Tobinai,K, AU - Takaue,Y, PY - 2004/3/30/pubmed PY - 2004/12/16/medline PY - 2004/3/30/entrez SP - 891 EP - 900 JF - Bone marrow transplantation JO - Bone Marrow Transplant VL - 33 IS - 9 N2 - The purpose of this study was to evaluate the feasibility and efficacy of allogeneic hematopoietic stem cell transplantation with a reduced-intensity regimen (RIST) in patients with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS). In all, 36 patients (median age 55 years) underwent RIST from an HLA-matched related donor between September 1999 and December 2002. The diagnoses included AML (n=14), leukemia evolving from MDS (n=10), and MDS (refractory anemia with excess blasts n=6, refractory anemia n=6). The RIST regimen consisted of purine analog (cladribine or fludarabine)/busulfan, with or without antithymocyte globulin. The regimen was well tolerated, and 34 patients achieved durable engraftment and most achieved remission after RIST. A total of 17 patients developed grade II-IV acute GVHD, and 27 developed chronic GVHD. Eight patients relapsed, and five of them received antithymocyte globulin (ATG) as part of the preparative regimen. A total of 12 patients died (four disease progression, six transplantation-related complications, and two others). Estimated 1-year disease-free survival (DFS) in low- and high-risk groups was 85 and 64%, respectively. We conclude that RIST can be performed safely in elderly patients with myeloid malignancies, and has therapeutic potential for those who fail conventional chemotherapy. In view of the significant association between GVHD or ATG and DFS, defined management of GVHD following RIST should become a major target of clinical research. SN - 0268-3369 UR - https://www.unboundmedicine.com/medline/citation/15048142/Reduced_intensity_stem_cell_transplantation_from_an_HLA_identical_sibling_donor_in_patients_with_myeloid_malignancies_ L2 - https://doi.org/10.1038/sj.bmt.1704477 DB - PRIME DP - Unbound Medicine ER -