A prospective multicenter trial of peripheral blood stem cell sibling allografts for acute myeloid leukemia in first complete remission using fludarabine-cyclophosphamide reduced intensity conditioning

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dc.contributor.authorGrigg, A.
dc.contributor.authorGibson, J.
dc.contributor.authorBardy, P.
dc.contributor.authorReynolds, J.
dc.contributor.authorShuttleworth, P.
dc.contributor.authorKoelmeyer, R.
dc.contributor.authorSzer, J.
dc.contributor.authorRoberts, A.
dc.contributor.authorTo, L.
dc.contributor.authorKennedy, G.
dc.contributor.authorBradstock, K.
dc.date.issued2007
dc.description.abstractThe role of allogeneic transplantation in patients with de novo acute myeloid leukemia in first complete remission (AML-CR1) is controversial. Aiming to preserve a graft-versus-leukemia effect, but minimize morbidity and mortality from conditioning-related toxicity and graft-versus-host disease (GVHD), we conducted a prospective multicenter study of reduced-intensity conditioning (RIC) as preparation for peripheral blood stem cell sibling allografts in patients with intermediate or poor risk AML-CR1. Conditioning consisted of fludarabine 125 mg/m(2) and cyclophosphamide 120 mg/kg. Thirty-four patients were transplanted with a median age of 45 years; 85% had intermediate risk cytogenetics. Early toxicity was minimal. The overall incidence of grade II-IV acute GVHD was low (21%), but the 3 patients (9%) who developed grade IV GVHD died. Donor T cell chimerism was rapid and generally complete, but complete myeloid chimerism was delayed. Thirteen patients (38%) relapsed, 12 within a year of transplant. The estimated disease-free survival (DFS) and overall survival at 2 years was 56% (95% confidence interval [CI] 39%-71%) and 68% (95% CI 50%-81%), respectively. The incidence of extensive chronic GVHD (cGVHD) was low (24% of surviving patients at 12 months) and most survivors had an excellent performance status. These observations justify a prospective comparison of RIC versus myeloablative conditioning allografts for AML-CR1.
dc.description.statementofresponsibilityA.P. Grigg, J. Gibson, P.G. Bardy, J. Reynolds, P. Shuttleworth, R.L. Koelmeyer, J. Szer, A.W. Roberts, L.B. To, G. Kennedy and K.F. Bradstock
dc.identifier.citationBiology of Blood and Marrow Transplantation, 2007; 13(5):560-567
dc.identifier.doi10.1016/j.bbmt.2006.12.449
dc.identifier.issn1083-8791
dc.identifier.issn1523-6536
dc.identifier.urihttp://hdl.handle.net/2440/43795
dc.language.isoen
dc.publisherCarden Jennings Publ Co Ltd
dc.rightsCopyright © 2007 American Society for Blood and Marrow Transplantation Published by Elsevier Inc.
dc.source.urihttps://doi.org/10.1016/j.bbmt.2006.12.449
dc.subjectHumans
dc.subjectLeukemia, Myeloid
dc.subjectGraft vs Host Disease
dc.subjectAcute Disease
dc.subjectCyclophosphamide
dc.subjectVidarabine
dc.subjectDisease-Free Survival
dc.subjectTransplantation Conditioning
dc.subjectHematopoietic Stem Cell Transplantation
dc.subjectPeripheral Blood Stem Cell Transplantation
dc.subjectTransplantation, Homologous
dc.subjectKarnofsky Performance Status
dc.subjectProspective Studies
dc.subjectFertility
dc.subjectChimerism
dc.subjectAdult
dc.subjectMiddle Aged
dc.subjectFemale
dc.subjectMale
dc.subjectKaplan-Meier Estimate
dc.titleA prospective multicenter trial of peripheral blood stem cell sibling allografts for acute myeloid leukemia in first complete remission using fludarabine-cyclophosphamide reduced intensity conditioning
dc.typeJournal article
pubs.publication-statusPublished

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