title: Long-term outcome of reduced-intensity allogeneic hematopoietic SCT in patients with AML in CR.
abstract: A total of 36 consecutive patients with AML in CR underwent reduced-intensity allogeneic hematopoietic SCT (RISCT) with fludarabine and melphalan conditioning. All patients were ineligible for myeloablative transplantation because of age or comorbidity. In total, 30 patients were in first CR and six patients were in second CR. Donors were siblings in 21 (58%) patients and were unrelated in 15 (42%) patients. Hematopoietic cell transplant specific comorbidity scores ≥3 were present in 26 (72%) patients. With a median follow-up of 52 months (range, 34-103 months), OS and PFS rates at 4 years were 71% (s.e., 8%) and 68% (s.e., 8%), respectively. At 4 years, the cumulative incidence of non-relapse mortality was 20% (s.e., 7%) and of relapse mortality was 8% (s.e., 5%). Neither OS nor PFS was affected by older age (>60 years), unrelated donor, melphalan dose, or comorbidity score. At last follow up, of the 24 surviving patients, 21 (88%) had performance status (ECOG) of 0 without any active chronic GVHD requiring steroids. Hence, RISCT with fludarabine and melphalan conditioning produces durable long-term remission in older patients with AML.
authors.affiliation: Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA. upopat@mdanderson.org
authors.forename: U
authors.initials: U
authors.lastname: Popat
authors.forename: M J
authors.initials: MJ
authors.lastname: de Lima
authors.forename: R M
authors.initials: RM
authors.lastname: Saliba
authors.forename: P
authors.initials: P
authors.lastname: Anderlini
authors.forename: B S
authors.initials: BS
authors.lastname: Andersson
authors.forename: A M
authors.initials: AM
authors.lastname: Alousi
authors.forename: C
authors.initials: C
authors.lastname: Hosing
authors.forename: Y
authors.initials: Y
authors.lastname: Nieto
authors.forename: S
authors.initials: S
authors.lastname: Parmar
authors.forename: I F
authors.initials: IF
authors.lastname: Khouri
authors.forename: P
authors.initials: P
authors.lastname: Kebriaei
authors.forename: M
authors.initials: M
authors.lastname: Qazilbash
authors.forename: R E
authors.initials: RE
authors.lastname: Champlin
authors.forename: S A
authors.initials: SA
authors.lastname: Giralt
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy / Q000601:surgery; D008297:Male; D008558:Melphalan / Q000008:administration & dosage / Q000009:adverse effects; D008875:Middle Aged; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000379:methods*; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D014740:Vidarabine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D055815:Young Adult
chemical_list: D014740:Vidarabine; C024352:fludarabine; D008558:Melphalan