Tags

Type your tag names separated by a space and hit enter

Nonmyeloablative allogeneic stem cell transplantation in elderly patients with hematological malignancies: results from the GITMO (Gruppo Italiano Trapianto Midollo Osseo) multicenter prospective clinical trial.
Am J Hematol. 2007 Oct; 82(10):863-6.AJ

Abstract

This study aimed to evaluate the efficacy of a nonmyeloablative conditioning consisting of fludarabine and TBI in patients aged > or =60 years.A total of 32 patients (median age 62 years; range 60-70) with hematological malignancies were treated with fludarabine (30 mg/m(2) x 3-5 days) and 200 cCy TBI followed by allogeneic hematopoietic stem cell transplantation (HSCT) from a matched-sibling donor. GVHD prophylaxis consisted of cyclosporine and mycophenolate. Neutrophil recovery occurred in all patients at a median time of 16 days (range 9-34). Six patients did not become granulocytopenic. On day +30, 10 patients had >95% donor chimerism and 19 patients had mixed chimerism. The cumulative probabilities of Grade II-IV acute GVHD and chronic GVHD were 48 and 83%, respectively. Transplant-related mortality at 100 days and 1 year was 6 and 10%, respectively. The probabilities of 2-year overall (OS) and progression-free survival (PFS) were 39 and 35%, respectively. The estimated 2-year probability of OS and PFS for patients in early disease stages were 77 and 64%, respectively, which were significantly higher than the survival and PFS estimates of 0% obtained in patients with advanced disease stages at the time of transplant. Our analysis would suggest that for patients older than 60, this regimen is well tolerated and associated with a low incidence of transplant-related mortality. The leukemic burden at time of transplant has proven to be the most important risk factor for the outcome.

Authors+Show Affiliations

Division of Hematology, San Giovanni Battista Hospital, Turin, Italy.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 available

Pub Type(s)

Clinical Trial
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17616972

Citation

Falda, Michele, et al. "Nonmyeloablative Allogeneic Stem Cell Transplantation in Elderly Patients With Hematological Malignancies: Results From the GITMO (Gruppo Italiano Trapianto Midollo Osseo) Multicenter Prospective Clinical Trial." American Journal of Hematology, vol. 82, no. 10, 2007, pp. 863-6.
Falda M, Busca A, Baldi I, et al. Nonmyeloablative allogeneic stem cell transplantation in elderly patients with hematological malignancies: results from the GITMO (Gruppo Italiano Trapianto Midollo Osseo) multicenter prospective clinical trial. Am J Hematol. 2007;82(10):863-6.
Falda, M., Busca, A., Baldi, I., Mordini, N., Bruno, B., Allione, B., Rambaldi, A., Morello, E., Narni, F., Santarone, S., Locatelli, F., & Bacigalupo, A. (2007). Nonmyeloablative allogeneic stem cell transplantation in elderly patients with hematological malignancies: results from the GITMO (Gruppo Italiano Trapianto Midollo Osseo) multicenter prospective clinical trial. American Journal of Hematology, 82(10), 863-6.
Falda M, et al. Nonmyeloablative Allogeneic Stem Cell Transplantation in Elderly Patients With Hematological Malignancies: Results From the GITMO (Gruppo Italiano Trapianto Midollo Osseo) Multicenter Prospective Clinical Trial. Am J Hematol. 2007;82(10):863-6. PubMed PMID: 17616972.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nonmyeloablative allogeneic stem cell transplantation in elderly patients with hematological malignancies: results from the GITMO (Gruppo Italiano Trapianto Midollo Osseo) multicenter prospective clinical trial. AU - Falda,Michele, AU - Busca,Alessandro, AU - Baldi,Ileana, AU - Mordini,Nicola, AU - Bruno,Benedetto, AU - Allione,Bernardino, AU - Rambaldi,Alessandro, AU - Morello,Enrico, AU - Narni,Franco, AU - Santarone,Stella, AU - Locatelli,Franco, AU - Bacigalupo,Andrea, AU - ,, PY - 2007/7/10/pubmed PY - 2007/11/9/medline PY - 2007/7/10/entrez SP - 863 EP - 6 JF - American journal of hematology JO - Am J Hematol VL - 82 IS - 10 N2 - This study aimed to evaluate the efficacy of a nonmyeloablative conditioning consisting of fludarabine and TBI in patients aged > or =60 years.A total of 32 patients (median age 62 years; range 60-70) with hematological malignancies were treated with fludarabine (30 mg/m(2) x 3-5 days) and 200 cCy TBI followed by allogeneic hematopoietic stem cell transplantation (HSCT) from a matched-sibling donor. GVHD prophylaxis consisted of cyclosporine and mycophenolate. Neutrophil recovery occurred in all patients at a median time of 16 days (range 9-34). Six patients did not become granulocytopenic. On day +30, 10 patients had >95% donor chimerism and 19 patients had mixed chimerism. The cumulative probabilities of Grade II-IV acute GVHD and chronic GVHD were 48 and 83%, respectively. Transplant-related mortality at 100 days and 1 year was 6 and 10%, respectively. The probabilities of 2-year overall (OS) and progression-free survival (PFS) were 39 and 35%, respectively. The estimated 2-year probability of OS and PFS for patients in early disease stages were 77 and 64%, respectively, which were significantly higher than the survival and PFS estimates of 0% obtained in patients with advanced disease stages at the time of transplant. Our analysis would suggest that for patients older than 60, this regimen is well tolerated and associated with a low incidence of transplant-related mortality. The leukemic burden at time of transplant has proven to be the most important risk factor for the outcome. SN - 0361-8609 UR - https://www.unboundmedicine.com/medline/citation/17616972/Nonmyeloablative_allogeneic_stem_cell_transplantation_in_elderly_patients_with_hematological_malignancies:_results_from_the_GITMO__Gruppo_Italiano_Trapianto_Midollo_Osseo__multicenter_prospective_clinical_trial_ L2 - https://doi.org/10.1002/ajh.20990 DB - PRIME DP - Unbound Medicine ER -