Journal of hematology and oncology, 2019-04, Vol.12 (1), p.44-44, Article 44
2019
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- Autor(en) / Beteiligte
- Titel
- Fludarabine-treosulfan compared to thiotepa-busulfan-fludarabine or FLAMSA as conditioning regimen for patients with primary refractory or relapsed acute myeloid leukemia: a study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation (EBMT)
- Ist Teil von
- Journal of hematology and oncology, 2019-04, Vol.12 (1), p.44-44, Article 44
- Ort / Verlag
- England: BioMed Central Ltd
- Erscheinungsjahr
- 2019
- Quelle
- SpringerLink
- Beschreibungen/Notizen
- Limited data is available to guide the choice of the conditioning regimen for patients with acute myeloid leukemia (AML) undergoing transplant with persistent disease. We retrospectively compared outcome of fludarabine-treosulfan (FT), thiotepa-busulfan-fludarabine (TBF), and sequential fludarabine, intermediate dose Ara-C, amsacrine, total body irradiation/busulfan, cyclophosphamide (FLAMSA) conditioning in patients with refractory or relapsed AML. Complete remission rates at day 100 were 92%, 80%, and 88% for FT, TBF, and FLAMSA, respectively (p = 0.13). Non-relapse mortality, incidence of relapse, acute (a) and chronic (c) graft-versus-host disease (GVHD) rates did not differ between the three groups. Overall survival at 2 years was 37% for FT, 24% for TBF, and 34% for FLAMSA (p = 0.10). Independent prognostic factors for survival were Karnofsky performance score and patient CMV serology (p = 0.01; p = 0.02), while survival was not affected by age at transplant. The use of anti-thymocyte globulin (ATG) was associated with reduced risk of grade III-IV aGVHD (p = 0.02) and cGVHD (p = 0.006), with no influence on relapse. In conclusion, FT, TBF, and FLAMSA regimens provided similar outcome in patients undergoing transplant with active AML. Survival was determined by patient characteristics as Karnofsky performance score and CMV serology, however was not affected by age at transplant. ATG appears able to reduce the incidence of acute and chronic GVHD without influencing relapse risk.
- Sprache
- Englisch
- Identifikatoren
- ISSN: 1756-8722eISSN: 1756-8722DOI: 10.1186/s13045-019-0727-4Titel-ID: cdi_doaj_primary_oai_doaj_org_article_1953bf4f9ad946aaad8280d944ff90cf
- Format
- –
- Schlagworte
- Active disease, Acute leukemia, Acute myelocytic leukemia, Acute myeloid leukemia, Acute myeloid leukemia (AML), Adult, Aged, Allogeneic transplantation, Antineoplastic agents, Antineoplastic Combined Chemotherapy Protocols - pharmacology, Antineoplastic Combined Chemotherapy Protocols - therapeutic use, Bone marrow, Bone marrow transplantation, Busulfan, Busulfan - analogs & derivatives, Busulfan - pharmacology, Busulfan - therapeutic use, Cancer research, Care and treatment, Chemotherapy, Complications and side effects, Conditioning regimen, Cyclophosphamide, Dosage and administration, Drug therapy, Europe, Female, Fludarabine, Globulins, Graft-versus-host reaction, Health aspects, Hematology, Hematopoietic stem cell transplantation, Hematopoietic Stem Cell Transplantation - methods, Humans, Leukemia, Leukemia, Myeloid, Acute - drug therapy, Leukemia, Myeloid, Acute - pathology, Male, Middle Aged, Mortality, Myeloid leukemia, Oncology, Physiological aspects, Radiation, Recurrence (Disease), Remission, Retrospective Studies, Serology, Sibling donor (MSD), Stem cells, Studies, Surgery, Survival, Thiotepa, Thiotepa - pharmacology, Thiotepa - therapeutic use, Thymocytes, Transplantation, Transplantation Conditioning - methods, Transplants & implants, Treosulfan, Unrelated donor (UD), Vidarabine - analogs & derivatives, Vidarabine - pharmacology, Vidarabine - therapeutic use, Young Adult