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- Title
Equivalent outcomes using reduced intensity or conventional myeloablative conditioning transplantation for patients aged 35 years and over with AML.
- Authors
Sébert, M; Porcher, R; Robin, M; Adès, L; Boissel, N; Raffoux, E; Xhaard, A; Dhedin, N; Larghero, J; Himberlin, C; Delmer, A; Fenaux, P; Dombret, H; Socié, G; de Latour, R P
- Abstract
Allogeneic hematopoietic stem cell transplantation provides the best chance of long-term survival for patients with AML, but is associated with an unpredictable risk of treatment-related mortality. From January 2000 to December 2010, we compared the outcomes for patients with AML aged 35 and over using reduced-intensity conditioning (RIC, N=60) or conventional myeloablative conditioning (MAC) regimen (N=72) transplantation. The median follow-up was 47 months (10-134). The 4-year cumulative incidence of non-relapse mortality was 21%. After adjusting for cytogenetic risk, gender donor/recipient mismatch and CD34+ cells, non-relapse mortality was significantly lower with the RIC regimen (P=0.027). The 4-year cumulative incidence of relapse was 38% and no difference was observed in the adjusted relapse rate between the two groups. The 4-year OS rate was 46%. Using both Cox regression and inverse probability-of-treatment weighted (IPTW) method, a similar OS rate was found with both regimens (adjusted hazard ratios for conventional vs reduced of 1.14 (95% CI 0.67-1.93, P=0.64) with Cox regression, and 1.14 (95% CI 0.55-2.34, P=0.73) with IPTW). Until prospective trials are completed, this study supports the use of a reduced-intensity regimen prior to transplantation for patients with AML aged 35 and over.
- Subjects
STEM cell transplantation; CYTOGENETICS; GRAFT versus host disease; MORTALITY; STEM cell culture
- Publication
Bone Marrow Transplantation, 2015, Vol 50, Issue 1, p74
- ISSN
0268-3369
- Publication type
Article
- DOI
10.1038/bmt.2014.199