TY - JOUR
T1 - Allogeneic stem-cell transplantation with fludarabine and 2-Gy TBI-based conditioning regimen for chronic hematological malignancy
T2 - A study of 25 consecutive patients and a literature review
AU - Micol, J. B.
AU - Berthon, C.
AU - Tricot, S.
AU - Terriou, L.
AU - Darré, S.
AU - Cracco, P.
AU - Boulanger, F.
AU - Bauters, F.
AU - Jouet, J. P.
AU - Yakoub-Agha, I.
PY - 2007/2/1
Y1 - 2007/2/1
N2 - We analyzed the outcome of 25 consecutive patients with chronic hematological malignancy who underwent allogeneic stem-cell transplantation conditioned with fludarabine (30mg/m2/day, thrice) and total body irradiation (2Gy). All patients received peripheral blood stem cells from an HLA-identical sibling donor. With a median follow-up of 769 days (range, 244-1231), the estimated 2-year overall survival (OS), event-free survival (EFS), transplantation-related mortality and relapse rates were 53%, 45%, 27%, and 39%, respectively. All patients had initial engraftment. Acute Grade II-IV graft-versus-host disease (GVHD) was recorded in 14 patients (56%), including 7 (28%) with Grade III-IV GVHD. Sixteen of the 23 patients (70%) who survived more than 100 days developed chronic GVHD. OS and EFS were adversely influenced by acute Grade III-IV GVHD (p < 0.001 and p = 0.033, respectively), but chronic GVHD seemed to favorably influence these two parameters (p = 0.03 and p > 0.001, respectively). Patients with full-donor chimerism at day 30 had lower relapse rates, as did those who received high-dose allogeneic CD8+ lymphocytes with their graft (p = 0.026). Collectively, these results provide a framework for refining nonmyeloablative conditioning, to improve outcome with an acceptable risk of GVHD.
AB - We analyzed the outcome of 25 consecutive patients with chronic hematological malignancy who underwent allogeneic stem-cell transplantation conditioned with fludarabine (30mg/m2/day, thrice) and total body irradiation (2Gy). All patients received peripheral blood stem cells from an HLA-identical sibling donor. With a median follow-up of 769 days (range, 244-1231), the estimated 2-year overall survival (OS), event-free survival (EFS), transplantation-related mortality and relapse rates were 53%, 45%, 27%, and 39%, respectively. All patients had initial engraftment. Acute Grade II-IV graft-versus-host disease (GVHD) was recorded in 14 patients (56%), including 7 (28%) with Grade III-IV GVHD. Sixteen of the 23 patients (70%) who survived more than 100 days developed chronic GVHD. OS and EFS were adversely influenced by acute Grade III-IV GVHD (p < 0.001 and p = 0.033, respectively), but chronic GVHD seemed to favorably influence these two parameters (p = 0.03 and p > 0.001, respectively). Patients with full-donor chimerism at day 30 had lower relapse rates, as did those who received high-dose allogeneic CD8+ lymphocytes with their graft (p = 0.026). Collectively, these results provide a framework for refining nonmyeloablative conditioning, to improve outcome with an acceptable risk of GVHD.
UR - http://www.scopus.com/inward/record.url?scp=34247887534&partnerID=8YFLogxK
U2 - 10.1080/10428190601059688
DO - 10.1080/10428190601059688
M3 - Article
C2 - 17325892
AN - SCOPUS:34247887534
SN - 1042-8194
VL - 48
SP - 321
EP - 329
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
IS - 2
ER -