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Comparative Study
. 2007 Apr;22(2):227-34.
doi: 10.3346/jkms.2007.22.2.227.

Allogeneic stem cell transplantation for patients with advanced hematological malignancies: comparison of fludarabine-based reduced intensity conditioning versus myeloablative conditioning

Inho Kim  1 , Kyung-Hun Lee, Yunhee Choi, Bhumsuk Keam, Nam Hee Koo, Sung-Soo Yoon, Keun-Young Yoo, Seonyang Park, Byoung Kook Kim
Affiliations
Comparative Study

Allogeneic stem cell transplantation for patients with advanced hematological malignancies: comparison of fludarabine-based reduced intensity conditioning versus myeloablative conditioning

Inho Kim et al. J Korean Med Sci. 2007 Apr.

Abstract

We compared the outcomes of allogeneic hematopoietic stem cell transplantation using reduced intensity and myeloablative conditioning for the treatment of patients with advanced hematological malignancies. A total of 75 adult patients received transplants from human leukocyte antigen-matched donors, coupled with either reduced intensity (n=40; fludarabine/melphalan, 28; fludarabine/cyclophosphamide, 12) or myeloablative conditioning (n=35, busufan/cyclophosphamide). The patients receiving reduced intensity conditioning were elderly, or exhibited contraindications for myeloablative conditioning. Neutrophil and platelet engraftment occurred more rapidly in the reduced intensity group (median, 9 days vs. 18 days in the myeloablative group, p<0.0001; median 12 days vs. 22 days in the myeloablative group, p=0.0001, respectively). Acute graft-versus-host disease (>or=grade II) occurred at comparable frequencies in both groups, while the incidence of hepatic veno-occlusive disease was lower in the reduced intensity group (3% vs. 20% in the myeloablative group, p=0.02). The overall 1-yr survival rates of the reduced intensity and myeloablative group patients were 44% and 15%, respectively (p=0.16). The results of present study indicate that patients with advanced hematological malignancies, even the elderly and those with major organ dysfunctions, might benefit from reduced intensity transplantation.

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Figures

Fig. 1
Fig. 1
Cumulative incidences of nonrelapse mortality of patents with advanced hematological malignancies treated by reduced intensity and myeloablative conditionings.
Fig. 2
Fig. 2
Overall survivals for patients with advanced hematological malignancies after reduced intensity and myeloablative transplantations.
Fig. 3
Fig. 3
Progression free survivals for patients with advanced hematological malignancies after reduced intensity and myeloablative transplantations.
See this image and copyright information in PMC

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