title: Comparison of conditioning regimens of various intensities for allogeneic hematopoietic SCT using HLA-identical sibling donors in AML and MDS with <10% BM blasts: a report from EBMT.
abstract: In this multicenter retrospective study, the long-term outcomes of 878 adults with AML and refractory anemia with excess blasts (RAEB) with BM blasts <10% who underwent transplantation with an HLA-identical sibling donor between 1998 and 2004 were analyzed according to four regimens of conditioning intensity: reduced-intensity conditioning (RIC) (either intermediate RIC (IntermRIC) or non-myeloablative (NMA) RIC), and myeloablative conditioning (MC) in 718 patients (either conventional MC or hyperintense MC. In multivariate cox analysis, patients undergoing NMA transplantation had lower non-relapse mortality risk in the first 100 days after transplantation (P<0.01), but a higher risk beyond day +100 (P=0.02), as well as higher relapse incidence in the first 12 months (P<0.01), but the risk was similar in all groups beyond 12 months. The probabilities of PFS and OS up to 7 years were significantly lower only in the NMA subgroup (P0.01 for both). The 7-year OS was 53%, 29%, 56% and 51%, respectively. Our data suggest that prospective studies comparing RIC regimens (especially IntermRIC) with MC are appropriate in patients with AML and RAEB who are in a non-advanced disease status.
authors.affiliation: Hematology Department, Division of Clinical Hematology, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Barcelona, Spain. rmartino@santpau.cat
authors.forename: R
authors.initials: R
authors.lastname: Martino
authors.forename: L
authors.initials: L
authors.lastname: de Wreede
authors.forename: M
authors.initials: M
authors.lastname: Fiocco
authors.forename: A
authors.initials: A
authors.lastname: van Biezen
authors.forename: P A
authors.initials: PA
authors.lastname: von dem Borne
authors.forename: R-M
authors.initials: RM
authors.lastname: Hamladji
authors.forename: L
authors.initials: L
authors.lastname: Volin
authors.forename: M
authors.initials: M
authors.lastname: Bornhäuser
authors.forename: M
authors.initials: M
authors.lastname: Robin
authors.forename: V
authors.initials: V
authors.lastname: Rocha
authors.forename: T
authors.initials: T
authors.lastname: de Witte
authors.forename: N
authors.initials: N
authors.lastname: Kröger
authors.forename: M
authors.initials: M
authors.lastname: Mohty
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D064591:Allografts; D000754:Anemia, Refractory, with Excess of Blasts / Q000401:mortality / Q000628:therapy*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D035781:Siblings; D015996:Survival Rate; D014019:Tissue Donors; D019172:Transplantation Conditioning / Q000379:methods*