ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION USING FLUDARABINE, MELPHALAN, TOTAL BODY IRRADIATION AS REDUCED-INTENSITY CONDITIONING REGIMEN FOR MYELOID MALIGNANCIES IN A SINGLE INSTITUTION.
(Abstract release date: 05/21/15)
EHA Library. Nemoto T. 06/12/15; 102920; PB2048
Disclosure(s): Saitama Medical Center, Saitama Medical University,Hamatology
Tomoe Nemoto
Contributions
Contributions
Abstract
Abstract: PB2048
Type: Publication Only
Background
Traditional transplant conditioning regimens have a limiting factor regarding co-morbidities or old age. Therefore, reduced intensity conditionig (RIC) regimens have been increasingly used since RIC regimens have lower rates of severe toxicity. Although RIC regimen for allogeneic hematopoietic transplants (allo-SCT) have become common usuful strategy for high risk myeloid malignancy, optimal conditioning regimen has not been established.
Aims
To define the role of RIC and MAC condition for patients with myeloid malignancy.
Methods
We retrospectively compared long-term outcomes of 38 consecutive transplants for adult patients with high-risk myeloid malignancy. Fifteen out of 38 patients who were older age (?55 year-old) or unfit received RIC regimen consisting of fludarabine (125mg/m2), melphalan (80mg/m2) and total body irradiation (TBI) (4Gy). Twenty-three patients received MAC regimens containing TBI (12Gy). All transplants received uniform strategy of graft versus host disease (GVHD) prophylaxis.
Results
All patients achieved engraftment in RIC comparing with 2 patients were engraftment failure in MAC. High level of treatment related toxicities was observed in patients with MAC rather than RIC. Compared with MAC, relapse rate was higher in RIC. Overall 2-year survival rate and relapse free survival were 42.3%, 36.7% in RIC and 43.5%, 39.1% in MAC respectively. Grade III to IV of acute GVHD were occured 6.6% in RIC and 30.4% in MAC, chronic GVHD were appeared 46.6% in RIC and 34.7% in MAC. In unitivariate analysis, good performance status (PS) and disease status CR, In multivariate analysis, disease status CR was the only prognostic variable for prolonged OS in high risk myeloid malignancy.
Summary
Our retrospective study, RIC was feasible and survival benefit was obtained in same level MAC. Lower tumor burden before transplantation but not conditioning intensity nor patient age intensity influenced longer survival. Although our study was small size of patient population, larger prospective randomized study should be required.
Keyword(s): Reduced intensity transplantation
Session topic: Publication Only
Type: Publication Only
Background
Traditional transplant conditioning regimens have a limiting factor regarding co-morbidities or old age. Therefore, reduced intensity conditionig (RIC) regimens have been increasingly used since RIC regimens have lower rates of severe toxicity. Although RIC regimen for allogeneic hematopoietic transplants (allo-SCT) have become common usuful strategy for high risk myeloid malignancy, optimal conditioning regimen has not been established.
Aims
To define the role of RIC and MAC condition for patients with myeloid malignancy.
Methods
We retrospectively compared long-term outcomes of 38 consecutive transplants for adult patients with high-risk myeloid malignancy. Fifteen out of 38 patients who were older age (?55 year-old) or unfit received RIC regimen consisting of fludarabine (125mg/m2), melphalan (80mg/m2) and total body irradiation (TBI) (4Gy). Twenty-three patients received MAC regimens containing TBI (12Gy). All transplants received uniform strategy of graft versus host disease (GVHD) prophylaxis.
Results
All patients achieved engraftment in RIC comparing with 2 patients were engraftment failure in MAC. High level of treatment related toxicities was observed in patients with MAC rather than RIC. Compared with MAC, relapse rate was higher in RIC. Overall 2-year survival rate and relapse free survival were 42.3%, 36.7% in RIC and 43.5%, 39.1% in MAC respectively. Grade III to IV of acute GVHD were occured 6.6% in RIC and 30.4% in MAC, chronic GVHD were appeared 46.6% in RIC and 34.7% in MAC. In unitivariate analysis, good performance status (PS) and disease status CR, In multivariate analysis, disease status CR was the only prognostic variable for prolonged OS in high risk myeloid malignancy.
Summary
Our retrospective study, RIC was feasible and survival benefit was obtained in same level MAC. Lower tumor burden before transplantation but not conditioning intensity nor patient age intensity influenced longer survival. Although our study was small size of patient population, larger prospective randomized study should be required.
Keyword(s): Reduced intensity transplantation
Session topic: Publication Only
Abstract: PB2048
Type: Publication Only
Background
Traditional transplant conditioning regimens have a limiting factor regarding co-morbidities or old age. Therefore, reduced intensity conditionig (RIC) regimens have been increasingly used since RIC regimens have lower rates of severe toxicity. Although RIC regimen for allogeneic hematopoietic transplants (allo-SCT) have become common usuful strategy for high risk myeloid malignancy, optimal conditioning regimen has not been established.
Aims
To define the role of RIC and MAC condition for patients with myeloid malignancy.
Methods
We retrospectively compared long-term outcomes of 38 consecutive transplants for adult patients with high-risk myeloid malignancy. Fifteen out of 38 patients who were older age (?55 year-old) or unfit received RIC regimen consisting of fludarabine (125mg/m2), melphalan (80mg/m2) and total body irradiation (TBI) (4Gy). Twenty-three patients received MAC regimens containing TBI (12Gy). All transplants received uniform strategy of graft versus host disease (GVHD) prophylaxis.
Results
All patients achieved engraftment in RIC comparing with 2 patients were engraftment failure in MAC. High level of treatment related toxicities was observed in patients with MAC rather than RIC. Compared with MAC, relapse rate was higher in RIC. Overall 2-year survival rate and relapse free survival were 42.3%, 36.7% in RIC and 43.5%, 39.1% in MAC respectively. Grade III to IV of acute GVHD were occured 6.6% in RIC and 30.4% in MAC, chronic GVHD were appeared 46.6% in RIC and 34.7% in MAC. In unitivariate analysis, good performance status (PS) and disease status CR, In multivariate analysis, disease status CR was the only prognostic variable for prolonged OS in high risk myeloid malignancy.
Summary
Our retrospective study, RIC was feasible and survival benefit was obtained in same level MAC. Lower tumor burden before transplantation but not conditioning intensity nor patient age intensity influenced longer survival. Although our study was small size of patient population, larger prospective randomized study should be required.
Keyword(s): Reduced intensity transplantation
Session topic: Publication Only
Type: Publication Only
Background
Traditional transplant conditioning regimens have a limiting factor regarding co-morbidities or old age. Therefore, reduced intensity conditionig (RIC) regimens have been increasingly used since RIC regimens have lower rates of severe toxicity. Although RIC regimen for allogeneic hematopoietic transplants (allo-SCT) have become common usuful strategy for high risk myeloid malignancy, optimal conditioning regimen has not been established.
Aims
To define the role of RIC and MAC condition for patients with myeloid malignancy.
Methods
We retrospectively compared long-term outcomes of 38 consecutive transplants for adult patients with high-risk myeloid malignancy. Fifteen out of 38 patients who were older age (?55 year-old) or unfit received RIC regimen consisting of fludarabine (125mg/m2), melphalan (80mg/m2) and total body irradiation (TBI) (4Gy). Twenty-three patients received MAC regimens containing TBI (12Gy). All transplants received uniform strategy of graft versus host disease (GVHD) prophylaxis.
Results
All patients achieved engraftment in RIC comparing with 2 patients were engraftment failure in MAC. High level of treatment related toxicities was observed in patients with MAC rather than RIC. Compared with MAC, relapse rate was higher in RIC. Overall 2-year survival rate and relapse free survival were 42.3%, 36.7% in RIC and 43.5%, 39.1% in MAC respectively. Grade III to IV of acute GVHD were occured 6.6% in RIC and 30.4% in MAC, chronic GVHD were appeared 46.6% in RIC and 34.7% in MAC. In unitivariate analysis, good performance status (PS) and disease status CR, In multivariate analysis, disease status CR was the only prognostic variable for prolonged OS in high risk myeloid malignancy.
Summary
Our retrospective study, RIC was feasible and survival benefit was obtained in same level MAC. Lower tumor burden before transplantation but not conditioning intensity nor patient age intensity influenced longer survival. Although our study was small size of patient population, larger prospective randomized study should be required.
Keyword(s): Reduced intensity transplantation
Session topic: Publication Only
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