Comparison of FLAMSA-based reduced intensity conditioning with treosulfan/fludarabine conditioning for patients with acute myeloid leukemia: an ALWP/EBMT analysis
Language English Country England, Great Britain Media print-electronic
Document type Journal Article
PubMed
30087463
DOI
10.1038/s41409-018-0288-0
PII: 10.1038/s41409-018-0288-0
Knihovny.cz E-resources
- MeSH
- Leukemia, Myeloid, Acute drug therapy mortality therapy MeSH
- Busulfan analogs & derivatives pharmacology therapeutic use MeSH
- Middle Aged MeSH
- Humans MeSH
- Survival Rate MeSH
- Transplantation Conditioning methods MeSH
- Aged MeSH
- Hematopoietic Stem Cell Transplantation methods MeSH
- Vidarabine analogs & derivatives pharmacology therapeutic use MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Names of Substances
- Busulfan MeSH
- fludarabine MeSH Browser
- treosulfan MeSH Browser
- Vidarabine MeSH
FLAMSA followed by sequential reduced intensity conditioning and treosulfan/fludarabine are frequently used conditioning approaches used in centers of the European Society for Blood and Marrow Transplantation (EBMT) for older patients with acute myeloid leukemia (AML). It is currently unknown whether any of these regimens is superior to the others in terms of disease control and toxicity. Using the Acute Leukemia Working Party/EBMT multicenter registry we compared the outcomes of AML patients 45-65 of age transplanted between the years 2007 and 2016. A total of 629 patients were included in the analysis: 281 in the Treo/Flu group, 203 in the FLAMSA/TBI group, and 145 in the FLAMSA/Busulfan group. In multivariate analysis, FLAMSA/TBI conditioned patients had a decreased risk of relapse (hazard ratio (HR) = 0.43; 95% confidence interval (CI), 0.25-0.75; p = 0.002) and superior leukemia-free survival (HR = 0.67; 95% CI, 0.45-0.98; p = 0.042) compared to Treo/Flu conditioned patients. Rates of acute graft-versus-host disease (GVHD) were significantly higher in the FLAMSA/TBI group compared to the Treo/Flu group (HR = 2.004; 95% CI, 1.09-3.67; p = 0.024). Overall survival, non-relapse mortality, and chronic GVHD were not significantly impacted by the specific regimen used. The choice of either FLAMSA/TBI, FLAMSA/Bu, or Treo/Flu results in no major impact on survival of older AML patients.
Center Hospitalier Lyon Sud Pavillon Marcel Bérard Bat 1G Service Hematologie Lyon France
Department of Hematology and Stem Cell Transplant Kings College Hospital London London UK
Department of Hematology and Stem Cell Transplant Vanderbilt University Nashville TN USA
Department of Internal Medicine BMT Unit University of Saarland University Hospital Homburg Germany
Department of Internal Medicine Hematooncology University Hospital Brno Brno Czech Republic
Deutsche Klinik fuer diagnostik KMT Zentrum Weisbaden Germany
EBMT Paris Office CEREST TC Department of Hematology Saint Antoine Hospital Paris France
Hematology Division Chaim Sheba Medical Center Tel Hashomer Tel Aviv University Tel Aviv Israel
Stem Cell Transplantation Unit HUCH Comprehensive Cancer Center Helsinki Finland
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