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Favourable outcome for patients with myeloid disorders treated with fludarabine-melphalan reduced-intensity conditioning and allogeneic bone marrow stem cell transplantation without the use of T-lymphocyte-depleting antibodies.
Eur J Haematol. 2004 Aug; 73(2):85-92.EJ

Abstract

We report the use of reduced-intensity conditioning (RIC)-matched sibling allogeneic bone marrow stem cell transplantation as a method of establishing a graft-vs.-leukaemia (GvL) effect against myeloid disorders using a fludarabine-melphalan protocol without the use of T-lymphocyte-depleting antibodies. The 16 patients in this group had predominantly poor-risk acute myeloid leukaemia (AML) (n=10), AML/myelodysplasia (MDS) (n=2) and MDS (n=4). All but one patient achieved full haematopoietic engraftment. Thirteen of 16 patients are alive and in continued complete remission on completion of this study with a median follow-up of 426 d (range 83-1524). The actuarial 4 yr disease-free and overall survival is 79% for both. Only one patient relapsed following transplant, giving a relapse rate of 6% during the study period. The treatment-related mortality was 13% (n= 2). Overall, acute graft-vs.-host disease (GvHD) occurred in 53% (8/15), with acute GvHD grade II or above occurring in 47% (7/15). In the 13 evaluable patients, chronic GvHD occurred in 46% (6/13), with this being extensive in three patients. These results suggest that a GvL effect can be delivered against poor-risk myeloid disorders with a low non-relapse mortality using this fludarabine-melphalan RIC protocol.

Authors+Show Affiliations

Department of Haematology, John Radcliffe Hospital, Oxford, UK. ram.malladi@ndcls.ox.ac.ukNo 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

15245506

Citation

Malladi, R K., et al. "Favourable Outcome for Patients With Myeloid Disorders Treated With Fludarabine-melphalan Reduced-intensity Conditioning and Allogeneic Bone Marrow Stem Cell Transplantation Without the Use of T-lymphocyte-depleting Antibodies." European Journal of Haematology, vol. 73, no. 2, 2004, pp. 85-92.
Malladi RK, Peniket AJ, Norton AE, et al. Favourable outcome for patients with myeloid disorders treated with fludarabine-melphalan reduced-intensity conditioning and allogeneic bone marrow stem cell transplantation without the use of T-lymphocyte-depleting antibodies. Eur J Haematol. 2004;73(2):85-92.
Malladi, R. K., Peniket, A. J., Norton, A. E., Campbell, A. J., Collins, G. P., Samol, J., Eagleton, H., Miller, E., Morgenstern, G., Jones, J., Keen-Mcguire, A., Barnardo, M., & Littlewood, T. J. (2004). Favourable outcome for patients with myeloid disorders treated with fludarabine-melphalan reduced-intensity conditioning and allogeneic bone marrow stem cell transplantation without the use of T-lymphocyte-depleting antibodies. European Journal of Haematology, 73(2), 85-92.
Malladi RK, et al. Favourable Outcome for Patients With Myeloid Disorders Treated With Fludarabine-melphalan Reduced-intensity Conditioning and Allogeneic Bone Marrow Stem Cell Transplantation Without the Use of T-lymphocyte-depleting Antibodies. Eur J Haematol. 2004;73(2):85-92. PubMed PMID: 15245506.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Favourable outcome for patients with myeloid disorders treated with fludarabine-melphalan reduced-intensity conditioning and allogeneic bone marrow stem cell transplantation without the use of T-lymphocyte-depleting antibodies. AU - Malladi,R K, AU - Peniket,A J, AU - Norton,A E, AU - Campbell,A J, AU - Collins,G P, AU - Samol,J, AU - Eagleton,H, AU - Miller,E, AU - Morgenstern,G, AU - Jones,J, AU - Keen-Mcguire,A, AU - Barnardo,M, AU - Littlewood,T J, PY - 2004/7/13/pubmed PY - 2004/9/4/medline PY - 2004/7/13/entrez SP - 85 EP - 92 JF - European journal of haematology JO - Eur J Haematol VL - 73 IS - 2 N2 - We report the use of reduced-intensity conditioning (RIC)-matched sibling allogeneic bone marrow stem cell transplantation as a method of establishing a graft-vs.-leukaemia (GvL) effect against myeloid disorders using a fludarabine-melphalan protocol without the use of T-lymphocyte-depleting antibodies. The 16 patients in this group had predominantly poor-risk acute myeloid leukaemia (AML) (n=10), AML/myelodysplasia (MDS) (n=2) and MDS (n=4). All but one patient achieved full haematopoietic engraftment. Thirteen of 16 patients are alive and in continued complete remission on completion of this study with a median follow-up of 426 d (range 83-1524). The actuarial 4 yr disease-free and overall survival is 79% for both. Only one patient relapsed following transplant, giving a relapse rate of 6% during the study period. The treatment-related mortality was 13% (n= 2). Overall, acute graft-vs.-host disease (GvHD) occurred in 53% (8/15), with acute GvHD grade II or above occurring in 47% (7/15). In the 13 evaluable patients, chronic GvHD occurred in 46% (6/13), with this being extensive in three patients. These results suggest that a GvL effect can be delivered against poor-risk myeloid disorders with a low non-relapse mortality using this fludarabine-melphalan RIC protocol. SN - 0902-4441 UR - https://www.unboundmedicine.com/medline/citation/15245506/Favourable_outcome_for_patients_with_myeloid_disorders_treated_with_fludarabine_melphalan_reduced_intensity_conditioning_and_allogeneic_bone_marrow_stem_cell_transplantation_without_the_use_of_T_lymphocyte_depleting_antibodies_ L2 - https://doi.org/10.1111/j.1600-0609.2004.00266.x DB - PRIME DP - Unbound Medicine ER -