Abstract
Hematopoietic cell transplantation (HCT) with non-myeloablative (NMA) conditioning for lymphoproliferative diseases (LD) includes fludarabine with and without low-dose TBI. Transplant outcomes were compared among patients aged ≥40 years with LD who received a HCT with TBI (N = 382) or no-TBI (N = 515) NMA from 2001 to 2011. The groups were comparable except for donor, graft, prophylaxis for GVHD, disease status and year of HCT. Cumulative incidences of grades II-IV GVHD at 100 days were 29% and 20% (P = 0.001) and of chronic GVHD at 1 year were 54% and 44% (P = 0.004) for TBI and no-TBI, respectively. Multivariate analysis of progression/relapse, treatment failure and mortality showed no outcome differences by conditioning. Full donor chimerism at day 100 was observed in 82% vs 64% in the TBI and no-TBI groups, respectively (P = 0.006). Subsets of the four most common conditioning/GVHD prophylaxis combinations demonstrated higher rates of grades II-IV acute (P<0.001) and chronic GVHD (P<0.001) among recipients of TBI-mycophenolate mofetil (MMF) compared with other combinations. TBI-based NMA conditioning induces faster full donor chimerism, but overall survival outcomes are comparable to no-TBI regimens. Combinations of TBI and MMF are associated with higher rates of GVHD without impact on survival outcomes in patients with LD.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 367-374 |
| Number of pages | 8 |
| Journal | Bone Marrow Transplantation |
| Volume | 50 |
| Issue number | 3 |
| DOIs | |
| State | Published - Jan 1 2015 |
| Externally published | Yes |
Fingerprint
ASJC Scopus subject areas
- Hematology
- Transplantation
Cite this
Comparison of non-myeloablative conditioning regimens for lymphoproliferative disorders. / Hong, S.; Le-Rademacher, Jennifer; Artz, A.; McCarthy, Pl; Logan, B.; Pasquini, M.
In: Bone Marrow Transplantation, Vol. 50, No. 3, 01.01.2015, p. 367-374.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Comparison of non-myeloablative conditioning regimens for lymphoproliferative disorders
AU - Hong, S.
AU - Le-Rademacher, Jennifer
AU - Artz, A.
AU - McCarthy, Pl
AU - Logan, B.
AU - Pasquini, M.
PY - 2015/1/1
Y1 - 2015/1/1
N2 - Hematopoietic cell transplantation (HCT) with non-myeloablative (NMA) conditioning for lymphoproliferative diseases (LD) includes fludarabine with and without low-dose TBI. Transplant outcomes were compared among patients aged ≥40 years with LD who received a HCT with TBI (N = 382) or no-TBI (N = 515) NMA from 2001 to 2011. The groups were comparable except for donor, graft, prophylaxis for GVHD, disease status and year of HCT. Cumulative incidences of grades II-IV GVHD at 100 days were 29% and 20% (P = 0.001) and of chronic GVHD at 1 year were 54% and 44% (P = 0.004) for TBI and no-TBI, respectively. Multivariate analysis of progression/relapse, treatment failure and mortality showed no outcome differences by conditioning. Full donor chimerism at day 100 was observed in 82% vs 64% in the TBI and no-TBI groups, respectively (P = 0.006). Subsets of the four most common conditioning/GVHD prophylaxis combinations demonstrated higher rates of grades II-IV acute (P<0.001) and chronic GVHD (P<0.001) among recipients of TBI-mycophenolate mofetil (MMF) compared with other combinations. TBI-based NMA conditioning induces faster full donor chimerism, but overall survival outcomes are comparable to no-TBI regimens. Combinations of TBI and MMF are associated with higher rates of GVHD without impact on survival outcomes in patients with LD.
AB - Hematopoietic cell transplantation (HCT) with non-myeloablative (NMA) conditioning for lymphoproliferative diseases (LD) includes fludarabine with and without low-dose TBI. Transplant outcomes were compared among patients aged ≥40 years with LD who received a HCT with TBI (N = 382) or no-TBI (N = 515) NMA from 2001 to 2011. The groups were comparable except for donor, graft, prophylaxis for GVHD, disease status and year of HCT. Cumulative incidences of grades II-IV GVHD at 100 days were 29% and 20% (P = 0.001) and of chronic GVHD at 1 year were 54% and 44% (P = 0.004) for TBI and no-TBI, respectively. Multivariate analysis of progression/relapse, treatment failure and mortality showed no outcome differences by conditioning. Full donor chimerism at day 100 was observed in 82% vs 64% in the TBI and no-TBI groups, respectively (P = 0.006). Subsets of the four most common conditioning/GVHD prophylaxis combinations demonstrated higher rates of grades II-IV acute (P<0.001) and chronic GVHD (P<0.001) among recipients of TBI-mycophenolate mofetil (MMF) compared with other combinations. TBI-based NMA conditioning induces faster full donor chimerism, but overall survival outcomes are comparable to no-TBI regimens. Combinations of TBI and MMF are associated with higher rates of GVHD without impact on survival outcomes in patients with LD.
UR - http://www.scopus.com/inward/record.url?scp=84938416290&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84938416290&partnerID=8YFLogxK
U2 - 10.1038/bmt.2014.269
DO - 10.1038/bmt.2014.269
M3 - Article
C2 - 25437248
AN - SCOPUS:84938416290
VL - 50
SP - 367
EP - 374
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
SN - 0268-3369
IS - 3
ER -