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Reduced-toxicity conditioning with treosulfan, fludarabine and ATG as preparative regimen for allogeneic stem cell transplantation (alloSCT) in elderly patients with secondary acute myeloid leukemia (sAML) or myelodysplastic syndrome (MDS).
Bone Marrow Transplant. 2006 Feb; 37(4):339-44.BM

Abstract

We investigated a dose-reduced conditioning regimen consisting of treosulfan and fludarabine followed by allogeneic stem cell transplantation (SCT) in 26 patients with secondary AML or MDS. Twenty patients were transplanted from matched or mismatched unrelated donors and six from HLA-identical sibling donors. The median age of the patients was 60 years (range, 44-70). None of the patients was eligible for a standard myeloablative preparative regimen. No graft-failure was observed, and leukocyte and platelet engraftment were observed after a median of 16 and 17 days, respectively. Acute graft-versus-host disease (GvHD) grade II-IV was seen in 23% and severe grade III GvHD in 12% of the patients. No patients experienced grade IV acute GvHD. Chronic GvHD was noted in 36% of the patients, which was extensive disease in 18%. The 2-year cumulative incidence of relapse was 21%. The relapse rate was higher in patients beyond CR1 or with intermediate two or high risk MDS (P = 0.02). The treatment-related mortality at day 100 was 28%. The 2-year estimated overall and disease-free survival was 36-34%, respectively. No difference in survival was seen between unrelated and related SCT.

Authors+Show Affiliations

Department of Bone Marrow Transplantation, University Hospital Hamburg-Eppendorf, Hamburg, Germany. nkroeger@uke.uni-hamburg.deNo 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
Comparative Study
Journal Article

Language

eng

PubMed ID

16415898

Citation

Kröger, N, et al. "Reduced-toxicity Conditioning With Treosulfan, Fludarabine and ATG as Preparative Regimen for Allogeneic Stem Cell Transplantation (alloSCT) in Elderly Patients With Secondary Acute Myeloid Leukemia (sAML) or Myelodysplastic Syndrome (MDS)." Bone Marrow Transplantation, vol. 37, no. 4, 2006, pp. 339-44.
Kröger N, Shimoni A, Zabelina T, et al. Reduced-toxicity conditioning with treosulfan, fludarabine and ATG as preparative regimen for allogeneic stem cell transplantation (alloSCT) in elderly patients with secondary acute myeloid leukemia (sAML) or myelodysplastic syndrome (MDS). Bone Marrow Transplant. 2006;37(4):339-44.
Kröger, N., Shimoni, A., Zabelina, T., Schieder, H., Panse, J., Ayuk, F., Wolschke, C., Renges, H., Dahlke, J., Atanackovic, D., Nagler, A., & Zander, A. (2006). Reduced-toxicity conditioning with treosulfan, fludarabine and ATG as preparative regimen for allogeneic stem cell transplantation (alloSCT) in elderly patients with secondary acute myeloid leukemia (sAML) or myelodysplastic syndrome (MDS). Bone Marrow Transplantation, 37(4), 339-44.
Kröger N, et al. Reduced-toxicity Conditioning With Treosulfan, Fludarabine and ATG as Preparative Regimen for Allogeneic Stem Cell Transplantation (alloSCT) in Elderly Patients With Secondary Acute Myeloid Leukemia (sAML) or Myelodysplastic Syndrome (MDS). Bone Marrow Transplant. 2006;37(4):339-44. PubMed PMID: 16415898.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reduced-toxicity conditioning with treosulfan, fludarabine and ATG as preparative regimen for allogeneic stem cell transplantation (alloSCT) in elderly patients with secondary acute myeloid leukemia (sAML) or myelodysplastic syndrome (MDS). AU - Kröger,N, AU - Shimoni,A, AU - Zabelina,T, AU - Schieder,H, AU - Panse,J, AU - Ayuk,F, AU - Wolschke,C, AU - Renges,H, AU - Dahlke,J, AU - Atanackovic,D, AU - Nagler,A, AU - Zander,A, PY - 2006/1/18/pubmed PY - 2006/6/10/medline PY - 2006/1/18/entrez SP - 339 EP - 44 JF - Bone marrow transplantation JO - Bone Marrow Transplant VL - 37 IS - 4 N2 - We investigated a dose-reduced conditioning regimen consisting of treosulfan and fludarabine followed by allogeneic stem cell transplantation (SCT) in 26 patients with secondary AML or MDS. Twenty patients were transplanted from matched or mismatched unrelated donors and six from HLA-identical sibling donors. The median age of the patients was 60 years (range, 44-70). None of the patients was eligible for a standard myeloablative preparative regimen. No graft-failure was observed, and leukocyte and platelet engraftment were observed after a median of 16 and 17 days, respectively. Acute graft-versus-host disease (GvHD) grade II-IV was seen in 23% and severe grade III GvHD in 12% of the patients. No patients experienced grade IV acute GvHD. Chronic GvHD was noted in 36% of the patients, which was extensive disease in 18%. The 2-year cumulative incidence of relapse was 21%. The relapse rate was higher in patients beyond CR1 or with intermediate two or high risk MDS (P = 0.02). The treatment-related mortality at day 100 was 28%. The 2-year estimated overall and disease-free survival was 36-34%, respectively. No difference in survival was seen between unrelated and related SCT. SN - 0268-3369 UR - https://www.unboundmedicine.com/medline/citation/16415898/Reduced_toxicity_conditioning_with_treosulfan_fludarabine_and_ATG_as_preparative_regimen_for_allogeneic_stem_cell_transplantation__alloSCT__in_elderly_patients_with_secondary_acute_myeloid_leukemia__sAML__or_myelodysplastic_syndrome__MDS__ L2 - https://doi.org/10.1038/sj.bmt.1705259 DB - PRIME DP - Unbound Medicine ER -