title: Predictive factors for outcomes after reduced intensity conditioning hematopoietic stem cell transplantation for hematological malignancies: a 10-year retrospective analysis from the Société Française de Greffe de Moelle et de Thérapie Cellulaire.
abstract: This retrospective study analyzed the impact of demographic and transplantation variables on outcomes of 1108 patients who have undergone allogeneic hematopoietic stem cell transplantation after reduced intensity conditioning (RIC HSCT) for hematological malignancies and were reported to the Société Française de Greffe de Moelle et de Thérapie Cellulaire registry between November 1994 and December 2004. Only 442 patients (40%) were in complete remission (CR) at time of transplantation. Peripheral blood stem cells were used in the majority of patients (n = 878; 79%), 255 patients received fludarabine and low-dose total body irradiation, while 465 patients (42%) fludarabine and busulfan with rabbit anti-thymocyte globulins (ATG). The impact of demographic and transplant variables was studied on overall (OS) and event-free survival (EFS) in univariate and multivariate analysis. With a median follow-up of 21 months, 3-year probability of OS and EFS was 42% and 30%, respectively, and treatment-related mortality was 15% at 2 years. The multivariate analysis showed a significant negative impact on OS and EFS of the absence of CR status before transplantation; conditioning regimen, including >10 mg/kg ATG; and minor ABO incompatibility. In conclusion, this study highlights the major impact on RIC HSCT outcome of disease status before transplantation, ATG dose and ABO incompatibility.
authors.affiliation: Service d'Hématologie, Hôpital Edouard Herriot, Lyon, France.
authors.forename: Mauricette
authors.initials: M
authors.lastname: Michallet
authors.forename: Quoc-Hung
authors.initials: QH
authors.lastname: Le
authors.forename: Mohamad
authors.initials: M
authors.lastname: Mohty
authors.forename: Thomas
authors.initials: T
authors.lastname: Prébet
authors.forename: Franck
authors.initials: F
authors.lastname: Nicolini
authors.forename: Jean Michel
authors.initials: JM
authors.lastname: Boiron
authors.forename: Hélène
authors.initials: H
authors.lastname: Esperou
authors.forename: Michel
authors.initials: M
authors.lastname: Attal
authors.forename: Noel
authors.initials: N
authors.lastname: Milpied
authors.forename: Bruno
authors.initials: B
authors.lastname: Lioure
authors.forename: Pierre
authors.initials: P
authors.lastname: Bordigoni
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Yakoub-Agha
authors.forename: Jean-Henri
authors.initials: JH
authors.lastname: Bourhis
authors.forename: Bernard
authors.initials: B
authors.lastname: Rio
authors.forename: Eric
authors.initials: E
authors.lastname: Deconinck
authors.forename: Marc
authors.initials: M
authors.lastname: Renaud
authors.forename: Zina
authors.initials: Z
authors.lastname: Chir
authors.forename: Didier
authors.initials: D
authors.lastname: Blaise
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000961:Antilymphocyte Serum / Q000008:administration & dosage; D002066:Busulfan / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006086:Graft vs Host Disease / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D019337:Hematologic Neoplasms / Q000175:diagnosis / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012042:Registries; D012074:Remission Induction; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D013995:Time; D019172:Transplantation Conditioning / Q000379:methods*; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D014740:Vidarabine / Q000008:administration & dosage / Q000031:analogs & derivatives
chemical_list: D000961:Antilymphocyte Serum; D014740:Vidarabine; D002066:Busulfan; C024352:fludarabine