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Comparison of Myeloablative Versus Reduced-Intensity Conditioning Regimens for Allogeneic Hematopoietic Stem Cell Transplantation in Acute Myeloid Leukemia: A Cohort Study
OBJECTIVE: Allogeneic hematopoietic stem cell transplantation (HSCT) is an effective treatment modality for a variety of malignant and non-malignant hematologic disorders. Myeloablative conditioning (MAC) and reduced-intensity conditioning (RIC) regimens could have different clinical outcomes. This...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Galenos Publishing
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6516104/ https://www.ncbi.nlm.nih.gov/pubmed/30717586 http://dx.doi.org/10.4274/tjh.galenos.2019.2018.0220 |
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author | Çiftçiler, Rafiye Göker, Hakan Demiroğlu, Haluk Aladağ, Elifcan Aksu, Salih Haznedaroğlu, İbrahim Celalettin Sayınalp, Nilgün Özcebe, Osman Tekin, Fatma Büyükaşık, Yahya |
author_facet | Çiftçiler, Rafiye Göker, Hakan Demiroğlu, Haluk Aladağ, Elifcan Aksu, Salih Haznedaroğlu, İbrahim Celalettin Sayınalp, Nilgün Özcebe, Osman Tekin, Fatma Büyükaşık, Yahya |
author_sort | Çiftçiler, Rafiye |
collection | PubMed |
description | OBJECTIVE: Allogeneic hematopoietic stem cell transplantation (HSCT) is an effective treatment modality for a variety of malignant and non-malignant hematologic disorders. Myeloablative conditioning (MAC) and reduced-intensity conditioning (RIC) regimens could have different clinical outcomes. This purpose of this study was to assess the long-term outcome of MAC versus RIC regimens in patients with acute myeloid leukemia (AML) undergoing allogeneic HSCT. MATERIALS AND METHODS: We retrospectively compared long-term outcomes with MAC and RIC regimens in patients with AML who underwent allo-HSCT at our tertiary transplantation center. RESULTS: We analyzed survival outcomes after MAC-HSCT versus RICHSCT among 107 adult patients with AML diagnosed from 2001 through 2017. Of those, 44 patients underwent a MAC regimen, whereas 63 patients received a RIC regimen. The median follow-up time was 37 months (range: 6-210) for the entire group. The 3-year overall survival (OS) for RIC and MAC patients was 67% and 60%, respectively (p>0.05). The 3-year progression-free survival (PFS) for RIC and MAC patients was 88% and 77%. In multivariate analysis, the type of conditioning regimen (RIC vs. MAC) did not influence PFS (p=0.24). Acute graft-versus-host disease (GVHD) was seen in five of the RIC patients and 9 of the MAC patients. Chronic GVHD was seen in 16 of the RIC patients and 6 of the MAC patients. There was no significant difference between the two groups in terms of acute GVHD (p=0.089), but there was a significant difference between the two groups in terms of chronic GVHD (p=0.03). CONCLUSION: This retrospective analysis confirmed that MAC and RIC regimens had a consistently equivalent rate of OS and PFS in AML patients who underwent allo-HSCT. The choice of MAC versus RIC conditioning regimen might be decided on the basis of patient and disease characteristics. |
format | Online Article Text |
id | pubmed-6516104 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Galenos Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-65161042019-06-01 Comparison of Myeloablative Versus Reduced-Intensity Conditioning Regimens for Allogeneic Hematopoietic Stem Cell Transplantation in Acute Myeloid Leukemia: A Cohort Study Çiftçiler, Rafiye Göker, Hakan Demiroğlu, Haluk Aladağ, Elifcan Aksu, Salih Haznedaroğlu, İbrahim Celalettin Sayınalp, Nilgün Özcebe, Osman Tekin, Fatma Büyükaşık, Yahya Turk J Haematol Research Article OBJECTIVE: Allogeneic hematopoietic stem cell transplantation (HSCT) is an effective treatment modality for a variety of malignant and non-malignant hematologic disorders. Myeloablative conditioning (MAC) and reduced-intensity conditioning (RIC) regimens could have different clinical outcomes. This purpose of this study was to assess the long-term outcome of MAC versus RIC regimens in patients with acute myeloid leukemia (AML) undergoing allogeneic HSCT. MATERIALS AND METHODS: We retrospectively compared long-term outcomes with MAC and RIC regimens in patients with AML who underwent allo-HSCT at our tertiary transplantation center. RESULTS: We analyzed survival outcomes after MAC-HSCT versus RICHSCT among 107 adult patients with AML diagnosed from 2001 through 2017. Of those, 44 patients underwent a MAC regimen, whereas 63 patients received a RIC regimen. The median follow-up time was 37 months (range: 6-210) for the entire group. The 3-year overall survival (OS) for RIC and MAC patients was 67% and 60%, respectively (p>0.05). The 3-year progression-free survival (PFS) for RIC and MAC patients was 88% and 77%. In multivariate analysis, the type of conditioning regimen (RIC vs. MAC) did not influence PFS (p=0.24). Acute graft-versus-host disease (GVHD) was seen in five of the RIC patients and 9 of the MAC patients. Chronic GVHD was seen in 16 of the RIC patients and 6 of the MAC patients. There was no significant difference between the two groups in terms of acute GVHD (p=0.089), but there was a significant difference between the two groups in terms of chronic GVHD (p=0.03). CONCLUSION: This retrospective analysis confirmed that MAC and RIC regimens had a consistently equivalent rate of OS and PFS in AML patients who underwent allo-HSCT. The choice of MAC versus RIC conditioning regimen might be decided on the basis of patient and disease characteristics. Galenos Publishing 2019-06 2019-05-03 /pmc/articles/PMC6516104/ /pubmed/30717586 http://dx.doi.org/10.4274/tjh.galenos.2019.2018.0220 Text en © Copyright 2019 by Turkish Society of Hematology / Turkish Journal of Hematology, Published by Galenos Publishing House. http://creativecommons.org/licenses/by/2.5/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Çiftçiler, Rafiye Göker, Hakan Demiroğlu, Haluk Aladağ, Elifcan Aksu, Salih Haznedaroğlu, İbrahim Celalettin Sayınalp, Nilgün Özcebe, Osman Tekin, Fatma Büyükaşık, Yahya Comparison of Myeloablative Versus Reduced-Intensity Conditioning Regimens for Allogeneic Hematopoietic Stem Cell Transplantation in Acute Myeloid Leukemia: A Cohort Study |
title | Comparison of Myeloablative Versus Reduced-Intensity Conditioning Regimens for Allogeneic Hematopoietic Stem Cell Transplantation in Acute Myeloid Leukemia: A Cohort Study |
title_full | Comparison of Myeloablative Versus Reduced-Intensity Conditioning Regimens for Allogeneic Hematopoietic Stem Cell Transplantation in Acute Myeloid Leukemia: A Cohort Study |
title_fullStr | Comparison of Myeloablative Versus Reduced-Intensity Conditioning Regimens for Allogeneic Hematopoietic Stem Cell Transplantation in Acute Myeloid Leukemia: A Cohort Study |
title_full_unstemmed | Comparison of Myeloablative Versus Reduced-Intensity Conditioning Regimens for Allogeneic Hematopoietic Stem Cell Transplantation in Acute Myeloid Leukemia: A Cohort Study |
title_short | Comparison of Myeloablative Versus Reduced-Intensity Conditioning Regimens for Allogeneic Hematopoietic Stem Cell Transplantation in Acute Myeloid Leukemia: A Cohort Study |
title_sort | comparison of myeloablative versus reduced-intensity conditioning regimens for allogeneic hematopoietic stem cell transplantation in acute myeloid leukemia: a cohort study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6516104/ https://www.ncbi.nlm.nih.gov/pubmed/30717586 http://dx.doi.org/10.4274/tjh.galenos.2019.2018.0220 |
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