Fludarabine/busulfan versus fludarabine/total-body-irradiation (2 Gy) as conditioning prior to allogeneic stem cell transplantation in patients (≥60 years) with acute myelogenous leukemia: a study of the acute leukemia working party of the EBMT

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

  • Thomas Heinicke
  • Myriam Labopin
  • Emmanuelle Polge
  • Dietger Niederwieser
  • Uwe Platzbecker
  • Sengeløv, Henrik
  • Goda Choi
  • Jan Cornelissen
  • Didier Blaise
  • Jürgen Kuball
  • Gwendolyn van Gorkom
  • Nicolaas Schaap
  • Victoria Potter
  • Franciane Paul
  • Bipin N. Savani
  • Arnon Nagler
  • Mohamad Mohty

Nonmyeloablative (NMA) conditioning regimens facilitate allogeneic stem cell transplantation (alloSCT) in elderly patients and/or in those with comorbidities. The acute leukemia working party (ALWP) of the European Society for Blood and Marrow Transplantation (EBMT) compared the outcomes of patients ≥60 years with AML in first complete remission (CR1), that had received an alloSCT following NMA conditioning, i.e. either fludarabine/busulfan (FB2) or fludarabine/total-body-irradiation-2Gy (FluTBI2Gy). A total of 1088 patients were included (median age 65 years). Donors were matched siblings (MSD) and matched unrelated donors (MUD) in 47% and 53%, respectively. In vivo T-cell depletion (TCD) was applied to 79% and none (0%) of patients in the FB2 and FluTBI2Gy groups, respectively. In the MSD group we found a trend for less extensive cGVHD in patients receiving FB2 with in vivo TCD, HR: 0.49, p = 0.08, and in those without worse NRM, HR: 2.14, p = 0.04, and a trend for more total cGVHD, HR: 1.61, p = 0.09. Patients transplanted from MUDs had a significantly higher incidence of total cGVHD, extensive cGVHD and a worse GRFS with FluTBI2Gy in comparison to FB2, HR: 2.44; p < 0.0001; HR 4.59; p < 0.00001 and HR: 1.35; p = 0.03, respectively. No differences were observed with respect to LFS, OS, RI, NRM, and aGVHD.

OriginalsprogEngelsk
TidsskriftBone Marrow Transplantation
Vol/bind55
Udgave nummer4
Sider (fra-til)729-739
Antal sider11
ISSN0268-3369
DOI
StatusUdgivet - 2020

ID: 261152173