Retrospective multicenter study of allogeneic peripheral blood stem cell transplantation followed by reduced-intensity conditioning or conventional myeloablative regimen.
This retrospective study compared the results of reduced-intensity conditioning stem cell transplantation (RIST) and a conventional myeloablative regimen (CST) followed by allogeneic peripheral blood stem cell transplantation. In this respect, 63 RISTs and 41 CSTs were performed at 5 transplantation centers in Korea between April 1998 and December 2002. The RIST group had more adverse pretransplant characteristics. More aggressive diseases, like acute myeloid or lymphoblastic leukemia, were included in the CST group, while the RIST group included more indolent diseases, like chronic myeloid leukemia or myeloma (p < 0.001). The incidence of acute graft-versus-host disease (GVHD) grades 2-4 was 29.1 and 57.9% for the RIST and CST groups, respectively (p = 0.010), yet the incidence of chronic GVHD was similar in the two groups (57.4 vs. 71.9%). With a median follow-up of 13 months (0.5-61 months, 17 months in 52 survivors), the 3-year overall (OS) and disease-free survival (DFS) was similar in the RIST and CST groups (p = 0.965 for OS, p = 0.545 for DFS). In a multivariate analysis, RIST (p = 0.010), good performance status (p = 0.006) and a higher CD34+ cell dose (p = 0.008) were all identified as independent favorable prognostic factors for OS. Accordingly, in the current study, RIST produced equivalent or acceptable results compared with CST in terms of OS. Therefore, a prospective randomized trial of RIST and CST is warranted.
Kim
Dong Hwan
DH
Department of Hematology/Oncology, Kyungpook National University Hospital, Daegu, Korea.
Sohn
Sang Kyun
SK
Baek
Jin Ho
JH
Kim
Jong Gwang
JG
Lee
Jong Wook
JW
Min
Woo Sung
WS
Kim
Dong Wook
DW
Choi
Seong-Jun
SJ
Lee
Je-Hwan
JH
Lee
Kyoo-Hyung
KH
Lee
Mark Hong
MH
Lee
Je Joong
JJ
Kim
Hyeoung Joon
HJ
Kim
Chun Choo
CC
Lee
Kyu Bo
KB
D000293:Adolescent; D000328:Adult; D005260:Female; D006086:Graft vs Host Disease; D019337:Hematologic Neoplasms / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D016019:Survival Analysis; D019172:Transplantation Conditioning