| Reduced-intensity conditioning with Fludarabin, oral Busulfan, and thymoglobulin allows long-term disease control and low transplant-related mortality in patients with hematological malignancies. | |
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MedLine Citation:
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PMID: 20850502 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The development of reduced-intensity conditioning regimens rather than myeloablative regimens for allogeneic stem cell transplantation has led to decreased treatment-related mortality and increased use of this treatment modality, especially in older patients with hematological malignancies. No randomized controlled trials have been performed resulting in determining effectiveness on phase II studies, which rarely report on long-term survival. MATERIALS AND METHODS: In an attempt to address this limitation, we analyzed a single-center cohort of 100 consecutive patients with hematological malignancies undergoing allogeneic stem cell transplantation from a human leukocyte antigen-matched related donor with median follow-up of 60 months. The reduced-intensity conditioning regimen consisted of oral Busulfan, rabbit anti-thymocyte globulin, and Fludarabin. RESULTS: Median age was 50 years (range, 18-64 years). The incidences of acute and chronic graft-vs.-host disease were 43% and 81%, respectively. The probability of nonrelapse mortality at 1 and 5 years was 15% and 25%, respectively. Nonrelapse mortality was adversely associated with acute graft-vs.-host disease (hazard ratio = 6; p = 0.0002). Of the 52 patients with measurable disease, 37 (71%) achieved a response. Relapse/progression occurred at a median of 11 months (range 1-52 months) in 21 patients, for a cumulative incidence of 22%. The probability of overall survival and progression-free survival at 5 years were 60% and 54%, respectively. Overall survival and progression-free survival were favorably influenced by having had previous autologous stem cell transplantation and a low CD34(+) cell dose. Overall survival, progression-free survival, and nonrelapse mortality improved over time in this cohort of patients. CONCLUSIONS: These results are encouraging for populations different in term of age, diagnosis, and disease status. |
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Authors:
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Didier Blaise; Laure Farnault; Catherine Faucher; Nicholas Marchetti; Sabine Fürst; Jean El Cheikh; Patrick Ladaique; Norbert Vey; Reda Bouabdallah; Anne-Marie Stoppa; Claude Lemarie; Boris Calmels; Thomas Prebet; Luca Castagna; Christian Chabannon; Mohamad Mohty; Benjamin Esterni |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-09-17 |
Journal Detail:
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Title: Experimental hematology Volume: 38 ISSN: 1873-2399 ISO Abbreviation: Exp. Hematol. Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-11-24 Completed Date: 2011-01-11 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0402313 Medline TA: Exp Hematol Country: Netherlands |
Other Details:
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Languages: eng Pagination: 1241-50 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 ISEH - Society for Hematology and Stem Cells. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Unite de Transplantation et de Therapie Cellulaire, Institut Paoli Calmettes, 232 Boulevard Sainte Marguerite, Marseille, France. blaised@marseille.fnclcc.fr |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Antibodies, Monoclonal / administration & dosage* Busulfan / administration & dosage* Female Graft vs Host Disease / mortality Hematologic Neoplasms / mortality, therapy* Hematopoietic Stem Cell Transplantation / mortality* Humans Male Middle Aged Transplantation Conditioning* Vidarabine / administration & dosage, analogs & derivatives* |
| Chemical | |
Reg. No./Substance:
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0/Antibodies, Monoclonal; 0/thymoglobulin; 21679-14-1/fludarabine; 55-98-1/Busulfan; 5536-17-4/Vidarabine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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