Allogeneic hematopoietic stem cell transplantation with non-myeloablative conditioning in patients with acute myelogenous leukemia eligible for conventional allografting: a prospective study.
Using a non-myeloablative stem cell trasplantation (NST) program, 25 allografts were prospectively given to 24 patients with acute myelogenous leukemia (AML) eligible for conventional allografting; 2 individuals had secondary forms of AML. The median age of the patients was 35 years, with a range of 12 to 56. All patients engrafted; median time to achieve an absolute neutrophil count > 0.5 x 10(9)/1 was 12 days (range 0-26), whereas the median time to a platelet count > 20 x 10(9)/1 was 13 days (range 0-26). Patients developed mixed chimerism 15 to 100 (median 30) days after the allograft. The follow-up periods range between 33 and 2670 days (median 450). The median post-transplant overall survival of the patients has not been reached and is above 89 months, whereas the 683 days both overall and progression-free survival is 66%. In 14 grafts (56%) acute GVHD ensued; in 12 cases grades I-II and in 2 cases grade IV which was fatal in both. In 9/19 patients (47%) limited chronic GVHD developed. In 22 cases (88%), the procedure could be completed fully on an outpatient basis. The 100-day and the transplant-related mortality were both 8%. NST appears to be an effective additional therapeutic option for patients with AML in remission and a matched donor available.
Ruiz-Argüelles
Guillermo J
GJ
Centro de Hematología y Medicina Interna de Puebla, Mexico. gruiz1@clinicaruiz.com
Gómez-Almaguer
David
D
David-Gomez-Rangel
Jose
J
Vela-Ojeda
Jorge
J
Cantú-Rodríguez
Olga G
OG
Jaime-Pérez
José C
JC
González-Llano
Oscar
O
Herrera-Garza
José L
JL
D000293:Adolescent; D000328:Adult; D002648:Child; D018572:Disease-Free Survival; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000145:classification / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012074:Remission Induction; D015996:Survival Rate; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D016896:Treatment Outcome