Allogeneic hematopoietic stem-cell transplantation for patients 50 years or older with myelodysplastic syndromes or secondary acute myeloid leukemia.
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Allogeneic hematopoietic stem-cell transplantation for patients 50 years or older with myelodysplastic syndromes or secondary acute myeloid leukemia. / Lim, Ziyi; Brand, Ronald; Martino, Rodrigo; van Biezen, Anja; Finke, Jürgen; Bacigalupo, Andrea; Beelen, Dietrich; Devergie, Agnes; Alessandrino, Emilio; Willemze, Roel; Ruutu, Tapani; Boogaerts, Marc; Falda, Michele; Jouet, Jean-Pierre; Niederwieser, Dietger; Kröger, Nicolaus; Mufti, Ghulam J; Witte, De; Theo, M.
in: J CLIN ONCOL, Jahrgang 28, Nr. 3, 3, 2010, S. 405-411.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - Allogeneic hematopoietic stem-cell transplantation for patients 50 years or older with myelodysplastic syndromes or secondary acute myeloid leukemia.
AU - Lim, Ziyi
AU - Brand, Ronald
AU - Martino, Rodrigo
AU - van Biezen, Anja
AU - Finke, Jürgen
AU - Bacigalupo, Andrea
AU - Beelen, Dietrich
AU - Devergie, Agnes
AU - Alessandrino, Emilio
AU - Willemze, Roel
AU - Ruutu, Tapani
AU - Boogaerts, Marc
AU - Falda, Michele
AU - Jouet, Jean-Pierre
AU - Niederwieser, Dietger
AU - Kröger, Nicolaus
AU - Mufti, Ghulam J
AU - Witte, De
AU - Theo, M
PY - 2010
Y1 - 2010
N2 - PURPOSE: This study was performed to examine the characteristics of transplant activity for patients with myelodysplastic syndromes (MDS) older than 50 years within the European Group for Blood and Marrow Transplantation, and to evaluate the factors predicting outcome within this group of patients. PATIENTS AND METHODS: We performed a retrospective multicenter analysis of 1,333 MDS patients age 50 years or older who received transplantation within the EBMT since 1998. The median recipient age was 56 years, with 884 patients (66%) age 50 to 60 years and 449 (34%) patients older than 60 years. There were 811 HLA-matched sibling (61%) and 522 (39%) unrelated donor transplants. Five hundred patients (38%) received standard myeloablative conditioning (SMC), and 833 (62%) received reduced intensity conditioning (RIC). RESULTS: The 4-year estimate for overall survival of the whole cohort was 31%. On multivariate analysis, use of RIC (hazard ratio [HR], 1.44; 95% CI, 1.13 to 1.84; P <.01) and advanced disease stage at transplantation (HR, 1.51; 95% CI, 1.18 to 1.93; P <.01) were associated with an increased relapse rate. In contrast, advanced disease stage at transplantation (HR, 1.43; 95% CI, 1.13 to 1.79; P = .01), use of an unrelated donor (P = .03), and RIC (HR, 0.79; 95% CI, 0.65 to 0.97; P = .03) were independent variables associated with nonrelapse mortality. Advanced disease stage at transplantation (HR, 1.55; 95% CI, 1.32 to 1.83; P <.01) was the major independent variable associated with an inferior 4-year overall survival. CONCLUSION: Allogeneic hematopoietic stem-cell transplantation remains a potential curative therapeutic option for many older patients with MDS. In this analysis, disease stage at time of transplantation, but not recipient age or the intensity of the conditioning regimens, was the most important factor influencing outcomes.
AB - PURPOSE: This study was performed to examine the characteristics of transplant activity for patients with myelodysplastic syndromes (MDS) older than 50 years within the European Group for Blood and Marrow Transplantation, and to evaluate the factors predicting outcome within this group of patients. PATIENTS AND METHODS: We performed a retrospective multicenter analysis of 1,333 MDS patients age 50 years or older who received transplantation within the EBMT since 1998. The median recipient age was 56 years, with 884 patients (66%) age 50 to 60 years and 449 (34%) patients older than 60 years. There were 811 HLA-matched sibling (61%) and 522 (39%) unrelated donor transplants. Five hundred patients (38%) received standard myeloablative conditioning (SMC), and 833 (62%) received reduced intensity conditioning (RIC). RESULTS: The 4-year estimate for overall survival of the whole cohort was 31%. On multivariate analysis, use of RIC (hazard ratio [HR], 1.44; 95% CI, 1.13 to 1.84; P <.01) and advanced disease stage at transplantation (HR, 1.51; 95% CI, 1.18 to 1.93; P <.01) were associated with an increased relapse rate. In contrast, advanced disease stage at transplantation (HR, 1.43; 95% CI, 1.13 to 1.79; P = .01), use of an unrelated donor (P = .03), and RIC (HR, 0.79; 95% CI, 0.65 to 0.97; P = .03) were independent variables associated with nonrelapse mortality. Advanced disease stage at transplantation (HR, 1.55; 95% CI, 1.32 to 1.83; P <.01) was the major independent variable associated with an inferior 4-year overall survival. CONCLUSION: Allogeneic hematopoietic stem-cell transplantation remains a potential curative therapeutic option for many older patients with MDS. In this analysis, disease stage at time of transplantation, but not recipient age or the intensity of the conditioning regimens, was the most important factor influencing outcomes.
M3 - SCORING: Zeitschriftenaufsatz
VL - 28
SP - 405
EP - 411
JO - J CLIN ONCOL
JF - J CLIN ONCOL
SN - 0732-183X
IS - 3
M1 - 3
ER -
