Long-Term Remissions in Patients with Myelodysplastic Syndrome and Secondary Acute Myelogenous Leukemia Undergoing Allogeneic Transplantation Following a Reduced Intensity Conditioning Regimen of 550 cGy Total Body Irradiation and Cyclophosphamide

Christopher Hallemeier, Mark D. Girgis, William G. Blum, Randy A. Brown, Hanna J. Khoury, Steven M. Devine, Ravi Vij, Hsu san Lin, John F. DiPersio, Douglas R. Adkins

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

We analyzed outcomes of patients with myelodysplastic syndrome (MDS) or secondary acute myelogenous leukemia (sAML) that were treated at our institution with a reduced intensity conditioning (RIC) regimen of 550-cGy total body irradiation and cyclophosphamide followed by related donor (RD) or unrelated donor (URD) transplantation. Fifty-one consecutive patients with MDS or sAML received this RIC regimen and URD (n = 30) or RD (n = 21) stem cells. Graft-versus-host disease prophylaxis consisted of cyclosporine alone (RD) or with corticosteroids and methotrexate (URD). Median patient age was 44 years. With a median follow-up of 3.7 years after transplantation in the 19 surviving patients (37%), Kaplan-Meier estimates of overall survival were 88%, 46%, 33%, and 11% for patients transplanted with sAML in remission, refractory anemia, refractory anemia with excess blasts, refractory anemia with excess blasts in transformation, or sAML refractory/untreated, respectively. Kaplan-Meier estimates of relapse-free survival were 75%, 46%, 33%, and 11%, respectively. Overall, the cumulative incidences of relapse and transplant-related mortality were 27% and 37%, respectively. In patients with MDS, this is an effective RIC regimen for allogeneic transplantation that can be used as an alternative to other RIC or conventional conditioning regimens.

Original languageEnglish (US)
Pages (from-to)749-757
Number of pages9
JournalBiology of Blood and Marrow Transplantation
Volume12
Issue number7
DOIs
StatePublished - Jul 1 2006
Externally publishedYes

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Whole-Body Irradiation
Myelodysplastic Syndromes
Homologous Transplantation
Acute Myeloid Leukemia
Cyclophosphamide
Unrelated Donors
Refractory Anemia with Excess of Blasts
Kaplan-Meier Estimate
Tissue Donors
Transplantation
Refractory Anemia
Recurrence
Survival
Graft vs Host Disease
Lymphocyte Activation
Methotrexate
Cyclosporine
Adrenal Cortex Hormones
Stem Cells
Transplants

Keywords

  • Allogeneic transplantation
  • Myelodysplastic syndrome
  • Reduced intensity conditioning

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Long-Term Remissions in Patients with Myelodysplastic Syndrome and Secondary Acute Myelogenous Leukemia Undergoing Allogeneic Transplantation Following a Reduced Intensity Conditioning Regimen of 550 cGy Total Body Irradiation and Cyclophosphamide. / Hallemeier, Christopher; Girgis, Mark D.; Blum, William G.; Brown, Randy A.; Khoury, Hanna J.; Devine, Steven M.; Vij, Ravi; Lin, Hsu san; DiPersio, John F.; Adkins, Douglas R.

In: Biology of Blood and Marrow Transplantation, Vol. 12, No. 7, 01.07.2006, p. 749-757.

Research output: Contribution to journalArticle

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abstract = "We analyzed outcomes of patients with myelodysplastic syndrome (MDS) or secondary acute myelogenous leukemia (sAML) that were treated at our institution with a reduced intensity conditioning (RIC) regimen of 550-cGy total body irradiation and cyclophosphamide followed by related donor (RD) or unrelated donor (URD) transplantation. Fifty-one consecutive patients with MDS or sAML received this RIC regimen and URD (n = 30) or RD (n = 21) stem cells. Graft-versus-host disease prophylaxis consisted of cyclosporine alone (RD) or with corticosteroids and methotrexate (URD). Median patient age was 44 years. With a median follow-up of 3.7 years after transplantation in the 19 surviving patients (37{\%}), Kaplan-Meier estimates of overall survival were 88{\%}, 46{\%}, 33{\%}, and 11{\%} for patients transplanted with sAML in remission, refractory anemia, refractory anemia with excess blasts, refractory anemia with excess blasts in transformation, or sAML refractory/untreated, respectively. Kaplan-Meier estimates of relapse-free survival were 75{\%}, 46{\%}, 33{\%}, and 11{\%}, respectively. Overall, the cumulative incidences of relapse and transplant-related mortality were 27{\%} and 37{\%}, respectively. In patients with MDS, this is an effective RIC regimen for allogeneic transplantation that can be used as an alternative to other RIC or conventional conditioning regimens.",
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AU - Devine, Steven M.

AU - Vij, Ravi

AU - Lin, Hsu san

AU - DiPersio, John F.

AU - Adkins, Douglas R.

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