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Allogeneic stem cell transplantation for patients with advanced hematological malignancies: comparison of fludarabine-based reduced intensity conditioning versus myeloablative conditioning

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Authors
Kim, Inho; Lee, Kyung-Hun; Choi, Yunhee; Keam, Bhumsuk; Koo, Nam Hee; Yoon, Sung-Soo; Yoo, Keun-Young; Park, Seonyang; Kim, Byoung Kook
Issue Date
2007-04-24
Publisher
Korean Academy of Medical Science
Citation
J Korean Med Sci. 2007 Apr;22(2):227-34.
Keywords
AdolescentAdultAgedBusulfan/*administration & dosageFemaleHematologic Neoplasms/*therapyHematopoietic Stem Cell Transplantation/*methodsHumansInternational CooperationMaleMiddle AgedMyeloablative Agonists/*administration & dosageTransplantation Conditioning/*methodsTransplantation, Homologous/methodsTreatment OutcomeVidarabine/administration & dosage/*analogs & derivatives
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.
ISSN
1011-8934 (Print)
Language
English
URI
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=17449929

http://hdl.handle.net/10371/29281
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College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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