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Search: WFRF:(Ahn Kwang Woo) > Hale Gregory A > Majhail Navneet S. > Fludarabine and Mel...

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Fludarabine and Melphalan Compared with Reduced Doses of Busulfan and Fludarabine Improve Transplantation Outcomes in Older Patients with Myelodysplastic Syndromes

Oran, Betul (author)
Univ Texas MD Anderson Canc Ctr, Dept Stem Cell Transplantat, Div Canc Med, Houston, TX 77030 USA.
Ahn, Kwang Woo (author)
Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA.;Med Coll Wisconsin, Inst Hlth & Equ, Div Biostat, Milwaukee, WI 53226 USA.
Fretham, Caitrin (author)
Ctr Int Blood & Marrow Transplant Res, Natl Marrow Donor Program Be The Match, Minneapolis, MN USA.
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Beitinjaneh, Amer (author)
Univ Miami, Div Transplantat & Cellular Therapy, Miami, FL USA.
Bashey, Asad (author)
Univ Miami, Div Transplantat & Cellular Therapy, Miami, FL USA.
Pawarode, Attaphol (author)
Univ Michigan, Sch Med, Dept Internal Med, Blood & Marrow Transplantat Program,Div Hematol O, Ann Arbor, MI USA.
Wirk, Baldeep (author)
Penn State Canc Inst, Bone Marrow Transplant Program, Hershey, PA USA.
Scott, Bart L. (author)
Fred Hutchinson Canc Res Ctr, 1124 Columbia St, Seattle, WA 98104 USA.
Savani, Bipin N. (author)
Vanderbilt Univ, Med Ctr, Dept Med, Div Hematol Oncol, Nashville, TN USA.
Bredeson, Christopher (author)
Ottawa Hosp, Blood & Marrow Transplant Program, Ottawa, ON, Canada.;Ottawa Hosp Res Inst, Ottawa, ON, Canada.
Weisdorf, Daniel (author)
Univ Minnesota, Dept Med, Div Hematol Oncol & Transplantat, Box 736 UMHC, Minneapolis, MN 55455 USA.
Marks, David I. (author)
Univ Hosp Bristol NHS Trust, Adult Bone Marrow Transplant, Bristol, Avon, England.
Rizzieri, David (author)
Duke Univ, Div Hematol Malignancies & Cellular Therapy, Durham, NC USA.
Copelan, Edward (author)
Atrium Hlth, Levine Canc Inst, Dept Hematol Oncol & Blood Disorders, Charlotte, NC USA.
Hildebrandt, Gerhard C. (author)
Univ Kentucky, Markey Canc Ctr, Lexington, KY USA.
Hale, Gregory A. (author)
Johns Hopkins All Childrens Hosp, Dept Hematol Oncol, St Petersburg, FL USA.
Murthy, Hemant S. (author)
Mayo Clin, Div Hematol Oncol, Blood & Marrow Transplantat Program, Jacksonville, FL 32224 USA.
Lazarus, Hillard M. (author)
Case Western Reserve Univ, Univ Hosp Cleveland Med Ctr, Cleveland, OH 44106 USA.
Cerny, Jan (author)
Univ Massachusetts, Med Ctr, Dept Med, Div Hematol Oncol, Worcester, MA USA.
Liesveld, Jane L. (author)
Univ Rochester, Med Ctr, Dept Med, Rochester, NY 14642 USA.
Yared, Jean A. (author)
Univ Maryland, Dept Med, Greenebaum Comprehens Canc Ctr, Blood & Marrow Transplantat Program,Div Hematol O, Baltimore, MD 21201 USA.
Yves-Cahn, Jean (author)
CHU Grenoble Alpes, Dept Hematol, Grenoble, France.
Szer, Jeffrey (author)
Peter MacCallum Canc Ctr, Clin Haematol, Melbourne, Vic, Australia.;Royal Melbourne Hosp, Melbourne, Vic, Australia.
Verdonck, Leo F. (author)
Isala Clin, Dept Hematol Oncol, Zwolle, Netherlands.
Aljurf, Mahmoud (author)
Department of Oncology, King Faisal Specialist Hospital Center & Research, Riyadh, Saudi Arabia
van der Poel, Marjolein (author)
Maastricht Univ, Med Ctr, Maastricht, Netherlands.
Litzow, Mark (author)
Mayo Clin, Div Hematol, Rochester, MN USA.;Mayo Clin, Transplant Ctr, Rochester, MN USA.
Kalaycio, Matt (author)
Cleveland Clin, Hematol & Med Oncol, Transplantat Ctr, Cleveland, OH 44106 USA.
Grunwald, Michael R. (author)
Atrium Hlth, Levine Canc Inst, Dept Hematol Oncol & Blood Disorders, Charlotte, NC USA.
AngelDiaz, Miguel (author)
Hosp Infantil Univ Nino Jesus, Dept Hematol Oncol, Madrid, Spain.
Sabloff, Mitchell (author)
Ottawa Hosp Res Inst, Ottawa, ON, Canada.;Univ Ottawa, Dept Med, Div Hematol, Ottawa, ON, Canada.
Kharfan-Dabaja, Mohamed A. (author)
Mayo Clin, Div Hematol Oncol, Blood & Marrow Transplantat Program, Jacksonville, FL 32224 USA.
Majhail, Navneet S. (author)
Cleveland Clin, Taussig Canc Inst, Blood & Marrow Transplant Program, Cleveland, OH 44106 USA.
Farhadfar, Nosha (author)
Univ Florida, Coll Med, Div Hematol Oncol, Gainesville, FL USA.
Reshef, Ran (author)
Columbia Univ, Med Ctr, Blood & Marrow Transplantat Program, New York, NY USA.;Columbia Univ, Med Ctr, Columbia Ctr Translat Immunol, New York, NY USA.
Olsson, Richard F. (author)
Uppsala universitet,Centrum för klinisk forskning i Sörmland (CKFD),Karolinska Inst, Dept Lab Med, Stockholm, Sweden
Gale, Robert Peter (author)
Imperial Coll London, Haematol Res Ctr, Dept Immunol & Inflammat, London, England.
Nakamura, Ryotaro (author)
City Hope Natl Med Ctr, Dept Hematol & Hematopoiet Cell Transplantat, Duarte, CA USA.
Seo, Sachiko (author)
Dokkyo Med Univ, Dept Hematol & Oncol, Mibu, Tochigi, Japan.
Chhabra, Saurabh (author)
Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA.;Med Coll Wisconsin, Dept Med, Div Hematol Oncol, Milwaukee, WI 53226 USA.
Hashmi, Shahrukh (author)
Mayo Clin, Dept Internal Med, Rochester, MN USA.;King Faisal Specialist Hosp & Res Ctr, Ctr Oncol, Riyadh, Saudi Arabia.
Farhan, Shatha (author)
Henry Ford Hosp, Henry Ford Hlth Syst, Bone Marrow Transplant Program, Detroit, MI 48202 USA.
Ganguly, Siddhartha (author)
Univ Kansas Hlth Syst, Div Hematol Malignancy & Cellular Therapeut, Kansas City, KS USA.
Nathan, Sunita (author)
Rush Univ, Med Ctr, Chicago, IL 60612 USA.
Nishihori, Taiga (author)
Department of Blood & Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, Florida
Jain, Tania (author)
Johns Hopkins Univ, Sch Med, Sidney Kimmel Comprehens Canc Ctr Johns Hopkins, Baltimore, MD USA.
Agrawal, Vaibhav (author)
Division of Hematology-Oncology, Indiana University School of Medicine, Indianapolis, Indiana
Bacher, Ulrike (author)
Univ Bern, Univ Hosp Bern, Inselspital, Dept Hematol, Bern, Switzerland.
Popat, Uday (author)
Univ Texas MD Anderson Canc Ctr, Dept Stem Cell Transplantat & Cellular Therapy, Div Canc Med, Houston, TX 77030 USA.
Saber, Wael (author)
Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA.
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Univ Texas MD Anderson Canc Ctr, Dept Stem Cell Transplantat, Div Canc Med, Houston, TX 77030 USA Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA.;Med Coll Wisconsin, Inst Hlth & Equ, Div Biostat, Milwaukee, WI 53226 USA. (creator_code:org_t)
Elsevier, 2021
2021
English.
In: Transplantation and Cellular Therapy. - : Elsevier. - 2666-6375 .- 2666-6367. ; 27:11, s. 921.e1-921.e10
Related links:
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  • Journal article (peer-reviewed)
Abstract Subject headings
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  • Reduced-intensity conditioning (RIC) regimens developed to extend the use of allogeneic hematopoietic stem cell transplantation (HSCT) to older patients have resulted in encouraging outcomes. We aimed to compare the 2 most commonly used RIC regimens, i.v. fludarabine with busulfan (FluBu) and fludarabine with melphalan (FluMel), in patients with myelodysplastic syndrome (MDS). Through the Center for International Blood and Marrow Transplant Research (CIBMTR), we identified 1045 MDS patients age >= 60 years who underwent first HSCT with a matched related or matched (8/8) unrelated donor using an RIC regimen. The CIBMTR's definition of RIC was used: a regimen that incorporated an i.v. busulfan total dose <= 7.2 mg/kg or a low-dose melphalan total dose <= 150 mg/m(2). The 2 groups, recipients of FluBu (n = 697) and recipients of FluMel (n = 448), were comparable in terms of disease- and transplantation-related characteristics except for the more frequent use of antithymocyte globulin or alemtuzumab in the FluBu group (39% versus 31%). The median age was 67 years in both groups. FluMel was associated with a reduced relapse incidence (RI) compared with FluBu, with a 1-year adjusted incidence of 26% versus 44% (P <=.0001). Transplantation-related mortality (TRM) was higher in the FluMel group (26% versus 16%; P <= .0001). Because the magnitude of improvement with FluMel in RI was greater than the improvement in TRM with FluBu, disease-free survival (DFS) was better at 1 year and beyond with FluMel compared with FluBu (48% versus 40% at 1 year [P =.02] and 35% versus 27% at 3 years [P =.01]). Overall survival was comparable in the 2 groups at 1 year (63% versus 61%; P =.4) but was significantly improved with FluMel compared with FluBu at 3 years (46% versus 39%; P =.03). Our results suggest that FluMel is associated with superior DFS compared with FluBu owing to reduced RI in older patients with MDS patients.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Hematologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Hematology (hsv//eng)

Keyword

MDS
Transplantation
Survival
Relapse
Melphalan

Publication and Content Type

ref (subject category)
art (subject category)

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