Comparison of Myeloablative Versus Reduced-Intensity Conditioning Regimens for Allogeneic Hematopoietic Stem Cell Transplantation in Acute Myeloid Leukemia: A Cohort Study
Objective: Allogeneic hematopoietic stem cell transplantation (HSCT) is an effective treatment modality for a variety of malignant and non-malignant hematologic disorders. Myeloablative conditioning (MAC) and reduced-intensity conditioning (RIC) regimens could have different clinical outcomes. This...
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| Format: | Article |
| Language: | English |
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Galenos Publishing House
2019-05-01
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| Series: | Turkish Journal of Hematology |
| Subjects: | |
| Online Access: | https://jag.journalagent.com/z4/download_fulltext.asp?pdir=tjh&un=TJH-20744 |
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| author | Rafiye Çiftçiler Hakan Göker Haluk Demiroğlu Elifcan Aladağ Salih Aksu İbrahim Calalettin Haznedaroğlu Nilgün Sayınalp Osman Özcebe Fatma Tekin Yahya Büyükaşık |
| author_facet | Rafiye Çiftçiler Hakan Göker Haluk Demiroğlu Elifcan Aladağ Salih Aksu İbrahim Calalettin Haznedaroğlu Nilgün Sayınalp Osman Özcebe Fatma Tekin Yahya Büyükaşık |
| author_sort | Rafiye Çiftçiler |
| collection | DOAJ |
| description | Objective: Allogeneic hematopoietic stem cell transplantation (HSCT) is an effective treatment modality for a variety of malignant and non-malignant hematologic disorders. Myeloablative conditioning (MAC) and reduced-intensity conditioning (RIC) regimens could have different clinical outcomes. This purpose of this study was to assess the long-term outcome of MAC versus RIC regimens in patients with acute myeloid leukemia (AML) undergoing allogeneic HSCT. Materials and Methods: We retrospectively compared long-term outcomes with MAC and RIC regimens in patients with AML who underwent allo-HSCT at our tertiary transplantation center. Results: We analyzed survival outcomes after MAC-HSCT versus RICHSCT among 107 adult patients with AML diagnosed from 2001 through 2017. Of those, 44 patients underwent a MAC regimen, whereas 63 patients received a RIC regimen. The median follow-up time was 37 months (range: 6-210) for the entire group. The 3-year overall survival (OS) for RIC and MAC patients was 67% and 60%, respectively (p>0.05). The 3-year progression-free survival (PFS) for RIC and MAC patients was 88% and 77%. In multivariate analysis, the type of conditioning regimen (RIC vs. MAC) did not influence PFS (p=0.24). Acute graft-versus-host disease (GVHD) was seen in five of the RIC patients and 9 of the MAC patients. Chronic GVHD was seen in 16 of the RIC patients and 6 of the MAC patients. There was no significant difference between the two groups in terms of acute GVHD (p=0.089), but there was a significant difference between the two groups in terms of chronic GVHD (p=0.03). Conclusion: This retrospective analysis confirmed that MAC and RIC regimens had a consistently equivalent rate of OS and PFS in AML patients who underwent allo-HSCT. The choice of MAC versus RIC conditioning regimen might be decided on the basis of patient and disease characteristics. |
| first_indexed | 2024-04-10T13:05:44Z |
| format | Article |
| id | doaj.art-249e8e927c3e481ba3badbac4e53cdd9 |
| institution | Directory Open Access Journal |
| issn | 1308-5263 |
| language | English |
| last_indexed | 2024-04-10T13:05:44Z |
| publishDate | 2019-05-01 |
| publisher | Galenos Publishing House |
| record_format | Article |
| series | Turkish Journal of Hematology |
| spelling | doaj.art-249e8e927c3e481ba3badbac4e53cdd92023-02-15T16:12:58ZengGalenos Publishing HouseTurkish Journal of Hematology1308-52632019-05-01362889610.4274/tjh.galenos.2019.2018.0220TJH-20744Comparison of Myeloablative Versus Reduced-Intensity Conditioning Regimens for Allogeneic Hematopoietic Stem Cell Transplantation in Acute Myeloid Leukemia: A Cohort StudyRafiye Çiftçiler0Hakan Göker1Haluk Demiroğlu2Elifcan Aladağ3Salih Aksu4İbrahim Calalettin Haznedaroğlu5Nilgün Sayınalp6Osman Özcebe7Fatma Tekin8Yahya Büyükaşık9Hacettepe University Faculty of Medicine, Department of Hematology, Ankara, TurkeyHacettepe University Faculty of Medicine, Department of Hematology, Ankara, TurkeyHacettepe University Faculty of Medicine, Department of Hematology, Ankara, TurkeyHacettepe University Faculty of Medicine, Department of Hematology, Ankara, TurkeyHacettepe University Faculty of Medicine, Department of Hematology, Ankara, TurkeyHacettepe University Faculty of Medicine, Department of Hematology, Ankara, TurkeyHacettepe University Faculty of Medicine, Department of Hematology, Ankara, TurkeyHacettepe University Faculty of Medicine, Department of Hematology, Ankara, TurkeyHacettepe University Faculty of Medicine, Department of Hematology, Ankara, TurkeyHacettepe University Faculty of Medicine, Department of Hematology, Ankara, TurkeyObjective: Allogeneic hematopoietic stem cell transplantation (HSCT) is an effective treatment modality for a variety of malignant and non-malignant hematologic disorders. Myeloablative conditioning (MAC) and reduced-intensity conditioning (RIC) regimens could have different clinical outcomes. This purpose of this study was to assess the long-term outcome of MAC versus RIC regimens in patients with acute myeloid leukemia (AML) undergoing allogeneic HSCT. Materials and Methods: We retrospectively compared long-term outcomes with MAC and RIC regimens in patients with AML who underwent allo-HSCT at our tertiary transplantation center. Results: We analyzed survival outcomes after MAC-HSCT versus RICHSCT among 107 adult patients with AML diagnosed from 2001 through 2017. Of those, 44 patients underwent a MAC regimen, whereas 63 patients received a RIC regimen. The median follow-up time was 37 months (range: 6-210) for the entire group. The 3-year overall survival (OS) for RIC and MAC patients was 67% and 60%, respectively (p>0.05). The 3-year progression-free survival (PFS) for RIC and MAC patients was 88% and 77%. In multivariate analysis, the type of conditioning regimen (RIC vs. MAC) did not influence PFS (p=0.24). Acute graft-versus-host disease (GVHD) was seen in five of the RIC patients and 9 of the MAC patients. Chronic GVHD was seen in 16 of the RIC patients and 6 of the MAC patients. There was no significant difference between the two groups in terms of acute GVHD (p=0.089), but there was a significant difference between the two groups in terms of chronic GVHD (p=0.03). Conclusion: This retrospective analysis confirmed that MAC and RIC regimens had a consistently equivalent rate of OS and PFS in AML patients who underwent allo-HSCT. The choice of MAC versus RIC conditioning regimen might be decided on the basis of patient and disease characteristics.https://jag.journalagent.com/z4/download_fulltext.asp?pdir=tjh&un=TJH-20744acute myeloid leukemiaallogeneic hematopoietic stem cell transplantationregimen |
| spellingShingle | Rafiye Çiftçiler Hakan Göker Haluk Demiroğlu Elifcan Aladağ Salih Aksu İbrahim Calalettin Haznedaroğlu Nilgün Sayınalp Osman Özcebe Fatma Tekin Yahya Büyükaşık Comparison of Myeloablative Versus Reduced-Intensity Conditioning Regimens for Allogeneic Hematopoietic Stem Cell Transplantation in Acute Myeloid Leukemia: A Cohort Study Turkish Journal of Hematology acute myeloid leukemia allogeneic hematopoietic stem cell transplantation regimen |
| title | Comparison of Myeloablative Versus Reduced-Intensity Conditioning Regimens for Allogeneic Hematopoietic Stem Cell Transplantation in Acute Myeloid Leukemia: A Cohort Study |
| title_full | Comparison of Myeloablative Versus Reduced-Intensity Conditioning Regimens for Allogeneic Hematopoietic Stem Cell Transplantation in Acute Myeloid Leukemia: A Cohort Study |
| title_fullStr | Comparison of Myeloablative Versus Reduced-Intensity Conditioning Regimens for Allogeneic Hematopoietic Stem Cell Transplantation in Acute Myeloid Leukemia: A Cohort Study |
| title_full_unstemmed | Comparison of Myeloablative Versus Reduced-Intensity Conditioning Regimens for Allogeneic Hematopoietic Stem Cell Transplantation in Acute Myeloid Leukemia: A Cohort Study |
| title_short | Comparison of Myeloablative Versus Reduced-Intensity Conditioning Regimens for Allogeneic Hematopoietic Stem Cell Transplantation in Acute Myeloid Leukemia: A Cohort Study |
| title_sort | comparison of myeloablative versus reduced intensity conditioning regimens for allogeneic hematopoietic stem cell transplantation in acute myeloid leukemia a cohort study |
| topic | acute myeloid leukemia allogeneic hematopoietic stem cell transplantation regimen |
| url | https://jag.journalagent.com/z4/download_fulltext.asp?pdir=tjh&un=TJH-20744 |
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