Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Çiftçiler, Rafiye, Göker, Hakan, Demiroğlu, Haluk, Aladağ, Elifcan, Aksu, Salih, Haznedaroğlu, İbrahim Celalettin, Sayınalp, Nilgün, Özcebe, Osman, Tekin, Fatma, Büyükaşık, Yahya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Galenos Publishing 2019
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
_version_ 1783418195384729600
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
work_keys_str_mv AT ciftcilerrafiye comparisonofmyeloablativeversusreducedintensityconditioningregimensforallogeneichematopoieticstemcelltransplantationinacutemyeloidleukemiaacohortstudy
AT gokerhakan comparisonofmyeloablativeversusreducedintensityconditioningregimensforallogeneichematopoieticstemcelltransplantationinacutemyeloidleukemiaacohortstudy
AT demirogluhaluk comparisonofmyeloablativeversusreducedintensityconditioningregimensforallogeneichematopoieticstemcelltransplantationinacutemyeloidleukemiaacohortstudy
AT aladagelifcan comparisonofmyeloablativeversusreducedintensityconditioningregimensforallogeneichematopoieticstemcelltransplantationinacutemyeloidleukemiaacohortstudy
AT aksusalih comparisonofmyeloablativeversusreducedintensityconditioningregimensforallogeneichematopoieticstemcelltransplantationinacutemyeloidleukemiaacohortstudy
AT haznedarogluibrahimcelalettin comparisonofmyeloablativeversusreducedintensityconditioningregimensforallogeneichematopoieticstemcelltransplantationinacutemyeloidleukemiaacohortstudy
AT sayınalpnilgun comparisonofmyeloablativeversusreducedintensityconditioningregimensforallogeneichematopoieticstemcelltransplantationinacutemyeloidleukemiaacohortstudy
AT ozcebeosman comparisonofmyeloablativeversusreducedintensityconditioningregimensforallogeneichematopoieticstemcelltransplantationinacutemyeloidleukemiaacohortstudy
AT tekinfatma comparisonofmyeloablativeversusreducedintensityconditioningregimensforallogeneichematopoieticstemcelltransplantationinacutemyeloidleukemiaacohortstudy
AT buyukasıkyahya comparisonofmyeloablativeversusreducedintensityconditioningregimensforallogeneichematopoieticstemcelltransplantationinacutemyeloidleukemiaacohortstudy