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Expanding transplant options to patients over 50 years. Improved outcome after reduced intensity conditioning mismatched-unrelated donor transplantation for patients with acute myeloid leukemia: a report from the Acute Leukemia Working Party of the EBMT

Standard

Expanding transplant options to patients over 50 years. Improved outcome after reduced intensity conditioning mismatched-unrelated donor transplantation for patients with acute myeloid leukemia: a report from the Acute Leukemia Working Party of the EBMT. / Savani, Bipin N; Labopin, Myriam; Kröger, Nicolaus; Finke, Jürgen; Ehninger, Gerhard; Niederwieser, Dietger; Schwerdtfeger, Rainer; Bunjes, Donald; Glass, Bertram; Socié, Gerard; Ljungman, Per; Craddock, Charles; Baron, Frédéric; Ciceri, Fabio; Gorin, Norbert Claude; Esteve, Jordi; Schmid, Christoph; Giebel, Sebastian; Mohty, Mohamad; Nagler, Arnon.

in: HAEMATOLOGICA, Jahrgang 101, Nr. 6, 06.2016, S. 773-80.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Savani, BN, Labopin, M, Kröger, N, Finke, J, Ehninger, G, Niederwieser, D, Schwerdtfeger, R, Bunjes, D, Glass, B, Socié, G, Ljungman, P, Craddock, C, Baron, F, Ciceri, F, Gorin, NC, Esteve, J, Schmid, C, Giebel, S, Mohty, M & Nagler, A 2016, 'Expanding transplant options to patients over 50 years. Improved outcome after reduced intensity conditioning mismatched-unrelated donor transplantation for patients with acute myeloid leukemia: a report from the Acute Leukemia Working Party of the EBMT', HAEMATOLOGICA, Jg. 101, Nr. 6, S. 773-80. https://doi.org/10.3324/haematol.2015.138180

APA

Savani, B. N., Labopin, M., Kröger, N., Finke, J., Ehninger, G., Niederwieser, D., Schwerdtfeger, R., Bunjes, D., Glass, B., Socié, G., Ljungman, P., Craddock, C., Baron, F., Ciceri, F., Gorin, N. C., Esteve, J., Schmid, C., Giebel, S., Mohty, M., & Nagler, A. (2016). Expanding transplant options to patients over 50 years. Improved outcome after reduced intensity conditioning mismatched-unrelated donor transplantation for patients with acute myeloid leukemia: a report from the Acute Leukemia Working Party of the EBMT. HAEMATOLOGICA, 101(6), 773-80. https://doi.org/10.3324/haematol.2015.138180

Vancouver

Savani BN, Labopin M, Kröger N, Finke J, Ehninger G, Niederwieser D et al. Expanding transplant options to patients over 50 years. Improved outcome after reduced intensity conditioning mismatched-unrelated donor transplantation for patients with acute myeloid leukemia: a report from the Acute Leukemia Working Party of the EBMT. HAEMATOLOGICA. 2016 Jun;101(6):773-80. https://doi.org/10.3324/haematol.2015.138180

Bibtex

@article{2d32d94edc564c4f84ba9605c1eccff3,
title = "Expanding transplant options to patients over 50 years. Improved outcome after reduced intensity conditioning mismatched-unrelated donor transplantation for patients with acute myeloid leukemia: a report from the Acute Leukemia Working Party of the EBMT",
abstract = "The outcome of patients undergoing HLA-matched unrelated donor allogeneic hematopoietic cell transplantation following reduced-intensity conditioning or myeloablative regimens is reported to be equivalent; however, it is not known if the intensity of the conditioning impacts outcomes after mismatched unrelated donor transplantation for acute myeloid leukemia. Eight hundred and eighty three patients receiving reduced-intensity conditioning were compared with 1041 myeloablative conditioning regimen recipients in the setting of mismatched unrelated donor transplantation. The donor graft was HLA-matched at 9/10 in 872 (83.8%) and at 8/10 in 169 (16.2%) myeloablative conditioning recipients, while in the reduced-intensity conditioning cohort, 754 (85.4%) and 129 (14.6%) were matched at 9/10 and 8/10 loci, respectively. Myeloablative conditioning regimen recipients were younger, 70% being <50 years of age compared to only 30% in the reduced-intensity conditioning group (P=0.0001). Significantly, more patients had secondary acute myeloid leukemia (P=0.04) and Karnofsky Performance Status score <90% (P=0.02) in the reduced-intensity conditioning group. Patients <50 and ≥50 years were analyzed separately. On multivariate analysis and after adjusting for differences between the two groups, reduced-intensity conditioning in patients age ≥50 years was associated with higher overall survival (HR 0.78; P=0.01), leukemia-free survival (HR 0.82; P=0.05), and decreased non-relapse mortality (HR 0.73; P=0.03). Relapse incidence (HR 0.91; P=0.51) and chronic graft-versus-host disease (HR 1.31; P=0.11) were, however, not significantly different. In patients <50 years old, there were no statistically significant differences in overall survival, leukemia-free survival, relapse incidence, non-relapse mortality, and chronic graft-versus-host-disease between the groups. Our study shows no significant outcome differences in patients younger than 50 years receiving reduced-intensity vs myeloablative conditioning regimens after mismatched unrelated donor transplantation. Furthermore, the data support the superiority of reduced-intensity conditioning regimens in older adults receiving transplants from mismatched unrelated donors.",
keywords = "Adult, Age Factors, Aged, Aged, 80 and over, Female, Graft Survival, Graft vs Host Disease, Hematopoietic Stem Cell Transplantation, Humans, Leukemia, Myeloid, Acute, Male, Middle Aged, Recurrence, Retrospective Studies, Survival Analysis, Transplantation Conditioning, Transplantation, Homologous, Treatment Outcome, Unrelated Donors, Young Adult, Journal Article, Multicenter Study",
author = "Savani, {Bipin N} and Myriam Labopin and Nicolaus Kr{\"o}ger and J{\"u}rgen Finke and Gerhard Ehninger and Dietger Niederwieser and Rainer Schwerdtfeger and Donald Bunjes and Bertram Glass and Gerard Soci{\'e} and Per Ljungman and Charles Craddock and Fr{\'e}d{\'e}ric Baron and Fabio Ciceri and Gorin, {Norbert Claude} and Jordi Esteve and Christoph Schmid and Sebastian Giebel and Mohamad Mohty and Arnon Nagler",
note = "Copyright{\textcopyright} Ferrata Storti Foundation.",
year = "2016",
month = jun,
doi = "10.3324/haematol.2015.138180",
language = "English",
volume = "101",
pages = "773--80",
journal = "HAEMATOLOGICA",
issn = "0390-6078",
publisher = "Ferrata Storti Foundation",
number = "6",

}

RIS

TY - JOUR

T1 - Expanding transplant options to patients over 50 years. Improved outcome after reduced intensity conditioning mismatched-unrelated donor transplantation for patients with acute myeloid leukemia: a report from the Acute Leukemia Working Party of the EBMT

AU - Savani, Bipin N

AU - Labopin, Myriam

AU - Kröger, Nicolaus

AU - Finke, Jürgen

AU - Ehninger, Gerhard

AU - Niederwieser, Dietger

AU - Schwerdtfeger, Rainer

AU - Bunjes, Donald

AU - Glass, Bertram

AU - Socié, Gerard

AU - Ljungman, Per

AU - Craddock, Charles

AU - Baron, Frédéric

AU - Ciceri, Fabio

AU - Gorin, Norbert Claude

AU - Esteve, Jordi

AU - Schmid, Christoph

AU - Giebel, Sebastian

AU - Mohty, Mohamad

AU - Nagler, Arnon

N1 - Copyright© Ferrata Storti Foundation.

PY - 2016/6

Y1 - 2016/6

N2 - The outcome of patients undergoing HLA-matched unrelated donor allogeneic hematopoietic cell transplantation following reduced-intensity conditioning or myeloablative regimens is reported to be equivalent; however, it is not known if the intensity of the conditioning impacts outcomes after mismatched unrelated donor transplantation for acute myeloid leukemia. Eight hundred and eighty three patients receiving reduced-intensity conditioning were compared with 1041 myeloablative conditioning regimen recipients in the setting of mismatched unrelated donor transplantation. The donor graft was HLA-matched at 9/10 in 872 (83.8%) and at 8/10 in 169 (16.2%) myeloablative conditioning recipients, while in the reduced-intensity conditioning cohort, 754 (85.4%) and 129 (14.6%) were matched at 9/10 and 8/10 loci, respectively. Myeloablative conditioning regimen recipients were younger, 70% being <50 years of age compared to only 30% in the reduced-intensity conditioning group (P=0.0001). Significantly, more patients had secondary acute myeloid leukemia (P=0.04) and Karnofsky Performance Status score <90% (P=0.02) in the reduced-intensity conditioning group. Patients <50 and ≥50 years were analyzed separately. On multivariate analysis and after adjusting for differences between the two groups, reduced-intensity conditioning in patients age ≥50 years was associated with higher overall survival (HR 0.78; P=0.01), leukemia-free survival (HR 0.82; P=0.05), and decreased non-relapse mortality (HR 0.73; P=0.03). Relapse incidence (HR 0.91; P=0.51) and chronic graft-versus-host disease (HR 1.31; P=0.11) were, however, not significantly different. In patients <50 years old, there were no statistically significant differences in overall survival, leukemia-free survival, relapse incidence, non-relapse mortality, and chronic graft-versus-host-disease between the groups. Our study shows no significant outcome differences in patients younger than 50 years receiving reduced-intensity vs myeloablative conditioning regimens after mismatched unrelated donor transplantation. Furthermore, the data support the superiority of reduced-intensity conditioning regimens in older adults receiving transplants from mismatched unrelated donors.

AB - The outcome of patients undergoing HLA-matched unrelated donor allogeneic hematopoietic cell transplantation following reduced-intensity conditioning or myeloablative regimens is reported to be equivalent; however, it is not known if the intensity of the conditioning impacts outcomes after mismatched unrelated donor transplantation for acute myeloid leukemia. Eight hundred and eighty three patients receiving reduced-intensity conditioning were compared with 1041 myeloablative conditioning regimen recipients in the setting of mismatched unrelated donor transplantation. The donor graft was HLA-matched at 9/10 in 872 (83.8%) and at 8/10 in 169 (16.2%) myeloablative conditioning recipients, while in the reduced-intensity conditioning cohort, 754 (85.4%) and 129 (14.6%) were matched at 9/10 and 8/10 loci, respectively. Myeloablative conditioning regimen recipients were younger, 70% being <50 years of age compared to only 30% in the reduced-intensity conditioning group (P=0.0001). Significantly, more patients had secondary acute myeloid leukemia (P=0.04) and Karnofsky Performance Status score <90% (P=0.02) in the reduced-intensity conditioning group. Patients <50 and ≥50 years were analyzed separately. On multivariate analysis and after adjusting for differences between the two groups, reduced-intensity conditioning in patients age ≥50 years was associated with higher overall survival (HR 0.78; P=0.01), leukemia-free survival (HR 0.82; P=0.05), and decreased non-relapse mortality (HR 0.73; P=0.03). Relapse incidence (HR 0.91; P=0.51) and chronic graft-versus-host disease (HR 1.31; P=0.11) were, however, not significantly different. In patients <50 years old, there were no statistically significant differences in overall survival, leukemia-free survival, relapse incidence, non-relapse mortality, and chronic graft-versus-host-disease between the groups. Our study shows no significant outcome differences in patients younger than 50 years receiving reduced-intensity vs myeloablative conditioning regimens after mismatched unrelated donor transplantation. Furthermore, the data support the superiority of reduced-intensity conditioning regimens in older adults receiving transplants from mismatched unrelated donors.

KW - Adult

KW - Age Factors

KW - Aged

KW - Aged, 80 and over

KW - Female

KW - Graft Survival

KW - Graft vs Host Disease

KW - Hematopoietic Stem Cell Transplantation

KW - Humans

KW - Leukemia, Myeloid, Acute

KW - Male

KW - Middle Aged

KW - Recurrence

KW - Retrospective Studies

KW - Survival Analysis

KW - Transplantation Conditioning

KW - Transplantation, Homologous

KW - Treatment Outcome

KW - Unrelated Donors

KW - Young Adult

KW - Journal Article

KW - Multicenter Study

U2 - 10.3324/haematol.2015.138180

DO - 10.3324/haematol.2015.138180

M3 - SCORING: Journal article

C2 - 26969081

VL - 101

SP - 773

EP - 780

JO - HAEMATOLOGICA

JF - HAEMATOLOGICA

SN - 0390-6078

IS - 6

ER -