title: Long-term survival with low toxicity after allogeneic transplantation for acute myeloid leukaemia and myelodysplasia using non-myeloablative conditioning without T cell depletion.
abstract: The toxicity burden and long-term anti-leukaemic effect of non-myeloablative (NMA) allogeneic haematopoietic stem-cell transplantation (AHSCT) for acute myeloid leukaemia (AML) and myelodysplasia (MDS) remains undefined. We report the outcome of 56 patients with AML/MDS transplanted from human leucocyte antigen-matched donors using NMA conditioning without T-cell depletion. With a median follow-up of 5 years, treatment-related mortality was 9% and current disease-free survival (CDFS) was 45% (overall) and 55% (patients transplanted in remission). Development of graft-versus-host disease upon withdrawal of post-transplant immunosuppression was associated with less relapse and better CDFS. These data confirm that NMA AHSCT without T-cell depletion is safe and can result in sustained remissions of AML/MDS.
authors.affiliation: Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, UK. j.k.davies@qmul.ac.uk
authors.forename: Jeff K
authors.initials: JK
authors.lastname: Davies
authors.forename: David
authors.initials: D
authors.lastname: Taussig
authors.forename: Heather
authors.initials: H
authors.lastname: Oakervee
authors.forename: Matthew
authors.initials: M
authors.lastname: Smith
authors.forename: Samir
authors.initials: S
authors.lastname: Agrawal
authors.forename: Jamie D
authors.initials: JD
authors.lastname: Cavenagh
authors.forename: John G
authors.initials: JG
authors.lastname: Gribben
mesh_terms: D000328:Adult; D003586:Cytomegalovirus Infections / Q000453:epidemiology; D018572:Disease-Free Survival; D005260:Female; D006085:Graft Survival; D006086:Graft vs Host Disease / Q000453:epidemiology; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007165:Immunosuppression Therapy; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D008212:Lymphocyte Depletion; D008232:Lymphoproliferative Disorders / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D018805:Sepsis / Q000453:epidemiology; D013601:T-Lymphocytes; D019172:Transplantation Conditioning / Q000379:methods* / Q000401:mortality; D014184:Transplantation, Homologous; D055815:Young Adult
keywords: Transplantation; acute myeloid leukaemia; myelodysplasia; reduced intensity conditioning