Title |
Fludarabine Melphalan reduced-intensity conditioning allotransplanation provides similar disease control in lymphoid and myeloid malignancies: analysis of 344 patients
|
---|---|
Published in |
Bone Marrow Transplantation, September 2013
|
DOI | 10.1038/bmt.2013.142 |
Pubmed ID | |
Authors |
A Bryant, I Nivison-Smith, E S Pillai, G Kennedy, A Kalff, D Ritchie, B George, M Hertzberg, S Patil, A Spencer, K Fay, P Cannell, L Berkahn, R Doocey, R Spearing, J Moore |
Abstract |
This was an Australasian Bone Marrow Transplant Recipient Registry (ABMTRR)-based retrospective study assessing the outcome of Fludarabine Melphalan (FluMel) reduced-intensity conditioning between 1998 and 2008. Median follow-up was 3.4 years. There were 344 patients with a median age of 54 years (18-68). In all, 234 patients had myeloid malignancies, with AML (n=166) being the commonest indication. There were 110 lymphoid patients with non-hodgkins lymphoma (NHL) (n=64) the main indication. TRM at day 100 was 14% with no significant difference between the groups. OS and disease-free survival (DFS) were similar between myeloid and lymphoid patients (57 and 50% at 3 years, respectively). There was no difference in cumulative incidence of relapse or GVHD between groups. Multivariate analysis revealed four significant adverse risk factors for DFS: donor other than HLA-identical sibling donor, not in remission at transplant, previous autologous transplant and recipient CMV positive. Chronic GVHD was associated with improved DFS in multivariate analysis predominantly due to a marked reduction in relapse (HR:0.44, P=0.003). This study confirms that FluMel provides durable and equivalent remissions in both myeloid and lymphoid malignancies. Disease stage and chronic GVHD remain important determinants of outcome for FluMel allografting. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 1 | 50% |
Unknown | 1 | 50% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Scientists | 2 | 100% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Japan | 1 | 3% |
Unknown | 28 | 97% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Other | 5 | 17% |
Researcher | 4 | 14% |
Student > Master | 3 | 10% |
Student > Ph. D. Student | 3 | 10% |
Student > Doctoral Student | 2 | 7% |
Other | 7 | 24% |
Unknown | 5 | 17% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 16 | 55% |
Nursing and Health Professions | 2 | 7% |
Biochemistry, Genetics and Molecular Biology | 1 | 3% |
Psychology | 1 | 3% |
Agricultural and Biological Sciences | 1 | 3% |
Other | 2 | 7% |
Unknown | 6 | 21% |