Allogeneic Stem Cell Transplantation for Patients with Advanced Hematological Malignancies: Comparison of Fludarabine-based Reduced Intensity Conditioning versus Myeloablative Conditioning.
10.3346/jkms.2007.22.2.227
- Author:
Inho KIM
1
;
Kyung Hun LEE
;
Yunhee CHOI
;
Bhumsuk KEAM
;
Nam Hee KOO
;
Sung Soo YOON
;
Keun Young YOO
;
Seonyang PARK
;
Byoung Kook KIM
Author Information
1. Department of Internal Medicine, Seoul National University College of Medicine, 28 Yeongeon-dong, Jongno-gu, Seoul, Korea. seonpark@plaza.snu.ac.kr
- Publication Type:Original Article ; Comparative Study ; Controlled Clinical Trial ; Research Support, Non-U.S. Gov't
- Keywords:
Allogeneic Stem Cell Transplantation;
Advanced Hematological Malignancy;
Reduced Intensity Conditioning
- MeSH:
Vidarabine/administration & dosage/*analogs & derivatives;
Treatment Outcome;
Transplantation, Homologous/methods;
Transplantation Conditioning/*methods;
Myeloablative Agonists/*administration & dosage;
Middle Aged;
Male;
International Cooperation;
Humans;
Hematopoietic Stem Cell Transplantation/*methods;
Hematologic Neoplasms/*therapy;
Female;
Busulfan/*administration & dosage;
Aged;
Adult;
Adolescent
- From:Journal of Korean Medical Science
2007;22(2):227-234
- CountryRepublic of Korea
- Language:English
-
Abstract:
We compared the outcomes of allogeneic hematopoietic stem cell transplantation using reduced intensity and myeloablative conditioning for the treatment of patients with advanced hematological malignancies. A total of 75 adult patients received transplants from human leukocyte antigen-matched donors, coupled with either reduced intensity (n=40; fludarabine/melphalan, 28; fludarabine/cyclophosphamide, 12) or myeloablative conditioning (n=35, busufan/cyclophosphamide). The patients receiving reduced intensity conditioning were elderly, or exhibited contraindications for myeloablative conditioning. Neutrophil and platelet engraftment occurred more rapidly in the reduced intensity group (median, 9 days vs. 18 days in the myeloablative group, p<0.0001; median 12 days vs. 22 days in the myeloablative group, p=0.0001, respectively). Acute graft-versus-host disease (> or =grade II) occurred at comparable frequencies in both groups, while the incidence of hepatic veno-occlusive disease was lower in the reduced intensity group (3% vs. 20% in the myeloablative group, p=0.02). The overall 1-yr survival rates of the reduced intensity and myeloablative group patients were 44% and 15%, respectively (p=0.16). The results of present study indicate that patients with advanced hematological malignancies, even the elderly and those with major organ dysfunctions, might benefit from reduced intensity transplantation.
