Long-Term Outcomes of Allogeneic Hematopoietic Cell Transplant with Fludarabine and Melphalan Conditioning and Tacrolimus/Sirolimus as Graft-versus-Host Disease Prophylaxis in Patients with Acute Lymphoblastic Leukemia.
Aged
Graft vs Host Disease
/ prevention & control
Hematopoietic Stem Cell Transplantation
Humans
Melphalan
/ therapeutic use
Precursor Cell Lymphoblastic Leukemia-Lymphoma
/ therapy
Retrospective Studies
Sirolimus
Tacrolimus
/ therapeutic use
Transplantation Conditioning
Vidarabine
/ analogs & derivatives
Acute lymphoblastic leukemia
Reduced-intensity conditioning with fludarabine and melphalan
Tacrolimus and sirolimus GVHD prophylactic regimen
Journal
Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
ISSN: 1523-6536
Titre abrégé: Biol Blood Marrow Transplant
Pays: United States
ID NLM: 9600628
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
received:
03
03
2020
revised:
14
04
2020
accepted:
14
04
2020
pubmed:
18
5
2020
medline:
24
6
2021
entrez:
17
5
2020
Statut:
ppublish
Résumé
Acute lymphoblastic leukemia (ALL) is associated with poor survival in older adults, and allogeneic hematopoietic cell transplant (HCT) with reduced-intensity conditioning (RIC) has been an increasingly used strategy in this population. At City of Hope we conducted a retrospective analysis of 72 patients who underwent allogeneic HCT with fludarabine and melphalan (FluMel) as the conditioning regimen between 2005 and 2018, from either a matched sibling or fully matched unrelated donor while in complete remission. Tacrolimus and sirolimus (T/S) were used as graft-versus-host disease (GVHD) prophylaxis. Overall survival and progression-free survival at 4 years post-HCT were 58% and 44%, respectively. The cumulative incidences of relapse/progression and nonrelapse mortality at 4 years were 34% and 22%, respectively. Patients with Philadelphia chromosome-positive (Ph+) ALL had a significantly lower cumulative incidence of relapse/progression (20% versus 48% for patients with Ph-negative status, P = .007). In conclusion, RIC HCT with FluMel conditioning and T/S GVHD prophylaxis was associated with favorable outcomes in patients with Ph+ ALL and should be considered as a viable consolidative therapy for adult patients with ALL.
Identifiants
pubmed: 32416253
pii: S1083-8791(20)30227-5
doi: 10.1016/j.bbmt.2020.04.015
pmc: PMC8822504
mid: NIHMS1770664
pii:
doi:
Substances chimiques
Vidarabine
FA2DM6879K
fludarabine
P2K93U8740
Melphalan
Q41OR9510P
Sirolimus
W36ZG6FT64
Tacrolimus
WM0HAQ4WNM
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
1425-1432Subventions
Organisme : NCI NIH HHS
ID : P30 CA033572
Pays : United States
Informations de copyright
Copyright © 2020 American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved.
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