Favourable outcome for patients with myeloid disorders treated with fludarabine-melphalan reduced-intensity conditioning and allogeneic bone marrow stem cell transplantation without the use of T-lymphocyte-depleting antibodies.

Malladi, R K; Peniket, A J; Norton, A E; Campbell, A J; Collins, G P; Samol, J; Eagleton, H; Miller, E; Morgenstern, G; Jones, J; Keen-Mcguire, A; Barnardo, M; Littlewood, T J

Malladi, R K; Peniket, A J; Norton, A E; Campbell, A J; Collins, G P; Samol, J; Eagleton, H; Miller, E; Morgenstern, G; Jones, J; Keen-Mcguire, A; Barnardo, M; Littlewood, T J.

Afiliación

Malladi RK; Department of Haematology, John Radcliffe Hospital, Oxford, UK. ram.malladi@ndcls.ox.ac.uk

Eur J Haematol ; 73(2): 85-92, 2004 Aug.

Article en En | MEDLINE | ID: mdl-15245506

RESUMEN

We report the use of reduced-intensity conditioning (RIC)-matched sibling allogeneic bone marrow stem cell transplantation as a method of establishing a graft-vs.-leukaemia (GvL) effect against myeloid disorders using a fludarabine-melphalan protocol without the use of T-lymphocyte-depleting antibodies. The 16 patients in this group had predominantly poor-risk acute myeloid leukaemia (AML) (n=10), AML/myelodysplasia (MDS) (n=2) and MDS (n=4). All but one patient achieved full haematopoietic engraftment. Thirteen of 16 patients are alive and in continued complete remission on completion of this study with a median follow-up of 426 d (range 83-1524). The actuarial 4 yr disease-free and overall survival is 79% for both. Only one patient relapsed following transplant, giving a relapse rate of 6% during the study period. The treatment-related mortality was 13% (n= 2). Overall, acute graft-vs.-host disease (GvHD) occurred in 53% (8/15), with acute GvHD grade II or above occurring in 47% (7/15). In the 13 evaluable patients, chronic GvHD occurred in 46% (6/13), with this being extensive in three patients. These results suggest that a GvL effect can be delivered against poor-risk myeloid disorders with a low non-relapse mortality using this fludarabine-melphalan RIC protocol.

Asunto(s)

Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico; Trasplante de Médula Ósea/métodos; Síndromes Mielodisplásicos/terapia; Acondicionamiento Pretrasplante/métodos; Vidarabina/análogos & derivados; Enfermedad Aguda; Adulto; Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación; Trasplante de Médula Ósea/efectos adversos; Trasplante de Médula Ósea/mortalidad; Supervivencia sin Enfermedad; Femenino; Supervivencia de Injerto; Enfermedad Injerto contra Huésped; Efecto Injerto vs Leucemia; Humanos; Leucemia Mieloide/terapia; Masculino; Melfalán/administración & dosificación; Persona de Mediana Edad; Síndromes Mielodisplásicos/mortalidad; Hermanos; Trasplante Homólogo; Resultado del Tratamiento; Vidarabina/administración & dosificación

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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Vidarabina / Síndromes Mielodisplásicos / Protocolos de Quimioterapia Combinada Antineoplásica / Trasplante de Médula Ósea / Acondicionamiento Pretrasplante Tipo de estudio: Guideline Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Eur J Haematol Asunto de la revista: HEMATOLOGIA Año: 2004 Tipo del documento: Article Pais de publicación: Reino Unido

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