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Outcomes of reduced-intensity transplantation for chronic myeloid leukemia: an analysis of prognostic factors from the Chronic Leukemia Working Party of the EBMT

Crawley, C ; Szydlo, R ; Lalancette, M ; Bacigalupo, A ; Lange, A ; Brune, M ; Juliusson, Gunnar LU ; Nagler, A ; Gratwohl, A and Passweg, J , et al. (2005) In Blood 106(9). p.2969-2976
Abstract
This study reports outcomes of allogeneic hematopoietic stem cell transplantation with reduced-intensity conditioning (RIC) in 186 patients with chronic myeloid leukemia (CML) from the European Group for Blood and Marrow Transplantation (EBMT). The median age was 50 years, and 64% were in first chronic phase (CP1), CP2 13%, accelerated phase 17%, and blast crises 6%. The median EBMT transplant score was 3. The day 100 transplantation-related mortality (TRM) was 6.1% (confidence interval [CI], 3.4%-11%) but rose to 23.3% (CI, 14%-27%) at 2 years. Fludarabine, busulfan, and antithymocyte globulin (Fd/Bu/ATG) was associated with the lowest TRM of 11.6% (CI, 4.7%-11%) at 1 year. Acute graft-versus-host disease (GvHD) grade II to IV occurred in... (More)
This study reports outcomes of allogeneic hematopoietic stem cell transplantation with reduced-intensity conditioning (RIC) in 186 patients with chronic myeloid leukemia (CML) from the European Group for Blood and Marrow Transplantation (EBMT). The median age was 50 years, and 64% were in first chronic phase (CP1), CP2 13%, accelerated phase 17%, and blast crises 6%. The median EBMT transplant score was 3. The day 100 transplantation-related mortality (TRM) was 6.1% (confidence interval [CI], 3.4%-11%) but rose to 23.3% (CI, 14%-27%) at 2 years. Fludarabine, busulfan, and antithymocyte globulin (Fd/Bu/ATG) was associated with the lowest TRM of 11.6% (CI, 4.7%-11%) at 1 year. Acute graft-versus-host disease (GvHD) grade II to IV occurred in 32% and chronic GvHD in 43% (extensive in 24%). ATG was associated with a lower incidence of chronic GvHD (cGvHD). The overall survival (OS) and progression-free survival (PFS) at 3 years were 58% (CI, 50%-66%) and 37% (CI, 30%-45%), respectively. Adverse OS was associated with advanced disease (relative risk [RR], 3.4). PFS was inferior in advanced disease (RR, 2.7) and a trend to improved outcomes with Fd/Bu/ATG (RR, 0.58). RIC allografts are feasible in CML in first or second CP. Since no other RIC regimen demonstrated superiority, Fd/Bu/ATG should be considered as baseline in future prospective trials. (Less)
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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Blood
volume
106
issue
9
pages
2969 - 2976
publisher
American Society of Hematology
external identifiers
  • wos:000232917400016
  • pmid:15998838
  • scopus:27644550034
ISSN
1528-0020
DOI
10.1182/blood-2004-09-3544
language
English
LU publication?
yes
additional info
The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Hematology/Transplantation (013022014)
id
1b84bd0c-5c15-4488-8d38-2a33b94d3937 (old id 216678)
alternative location
http://bloodjournal.hematologylibrary.org/cgi/reprint/106/9/2969?ck=nck
date added to LUP
2016-04-01 12:12:06
date last changed
2022-07-29 23:35:32
@article{1b84bd0c-5c15-4488-8d38-2a33b94d3937,
  abstract     = {{This study reports outcomes of allogeneic hematopoietic stem cell transplantation with reduced-intensity conditioning (RIC) in 186 patients with chronic myeloid leukemia (CML) from the European Group for Blood and Marrow Transplantation (EBMT). The median age was 50 years, and 64% were in first chronic phase (CP1), CP2 13%, accelerated phase 17%, and blast crises 6%. The median EBMT transplant score was 3. The day 100 transplantation-related mortality (TRM) was 6.1% (confidence interval [CI], 3.4%-11%) but rose to 23.3% (CI, 14%-27%) at 2 years. Fludarabine, busulfan, and antithymocyte globulin (Fd/Bu/ATG) was associated with the lowest TRM of 11.6% (CI, 4.7%-11%) at 1 year. Acute graft-versus-host disease (GvHD) grade II to IV occurred in 32% and chronic GvHD in 43% (extensive in 24%). ATG was associated with a lower incidence of chronic GvHD (cGvHD). The overall survival (OS) and progression-free survival (PFS) at 3 years were 58% (CI, 50%-66%) and 37% (CI, 30%-45%), respectively. Adverse OS was associated with advanced disease (relative risk [RR], 3.4). PFS was inferior in advanced disease (RR, 2.7) and a trend to improved outcomes with Fd/Bu/ATG (RR, 0.58). RIC allografts are feasible in CML in first or second CP. Since no other RIC regimen demonstrated superiority, Fd/Bu/ATG should be considered as baseline in future prospective trials.}},
  author       = {{Crawley, C and Szydlo, R and Lalancette, M and Bacigalupo, A and Lange, A and Brune, M and Juliusson, Gunnar and Nagler, A and Gratwohl, A and Passweg, J and Komarnicki, M and Vitek, A and Mayer, J and Zander, A and Sierra, J and Rambaldi, A and Ringden, O and Niederwieser, D and Apperley, JF}},
  issn         = {{1528-0020}},
  language     = {{eng}},
  number       = {{9}},
  pages        = {{2969--2976}},
  publisher    = {{American Society of Hematology}},
  series       = {{Blood}},
  title        = {{Outcomes of reduced-intensity transplantation for chronic myeloid leukemia: an analysis of prognostic factors from the Chronic Leukemia Working Party of the EBMT}},
  url          = {{http://dx.doi.org/10.1182/blood-2004-09-3544}},
  doi          = {{10.1182/blood-2004-09-3544}},
  volume       = {{106}},
  year         = {{2005}},
}