Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Sep;36(9):1152-6.
doi: 10.1016/j.leukres.2012.04.022. Epub 2012 Jun 5.

Reduced intensity allogeneic hematopoietic stem cell transplantation for MDS using tacrolimus/sirolimus-based GVHD prophylaxis

Ryotaro Nakamura  1 , Joycelynne M Palmer, Margaret R O'Donnell, Tracey Stiller, Sandra H Thomas, Joseph Chao, Joseph Alvarnas, Pablo M Parker, Vinod Pullarkat, Rodrigo Maegawa, Anthony S Stein, David S Snyder, Ravi Bhatia, Karen Chang, Shirong Wang, Ji-Lian Cai, David Senitzer, Stephen J Forman
Affiliations

Reduced intensity allogeneic hematopoietic stem cell transplantation for MDS using tacrolimus/sirolimus-based GVHD prophylaxis

Ryotaro Nakamura et al. Leuk Res. 2012 Sep.

Abstract

We report a consecutive series of 59 patients with MDS who underwent reduced-intensity hematopoietic stem cell transplantation (RI-HSCT) with fludarabine/melphalan conditioning and tacrolimus/sirolimus-based GVHD prophylaxis. Two-year OS, EFS, and relapse incidences were 75.1%, 65.2%, and 20.9%, respectively. The cumulative incidence of non-relapse mortality at 100 days, 1 year, and 2 years was 3.4%, 8.5%, and 10.5%, respectively. The incidence of grade II-IV acute GVHD was 35.4%; grade III-IV was 18.6%. Forty of 55 evaluable patients developed chronic GVHD; of these 35 were extensive grade. This RI-HSCT protocol produces encouraging outcomes in MDS patients, and tacrolimus/sirolimus-based GVHD prophylaxis may contribute to that promising result.

PubMed Disclaimer

Figures

Figure 1
Figure 1. Outcomes
Panel A shows the probability of overall survival, from date of transplant to death from any cause and Panel B shows event-free survival from date of transplant to death, relapse, progression, second transplant or engraftment failure., Panel C depicts the cumulative incidence of relapse/progression (RI), and Panel D, the cumulative incidence of non-relapse mortality (NRM), RI and NRM were calculated as competing risks. Non-engraftment was also treated as a competing risk for both RI and NRM.
See this image and copyright information in PMC

References

    1. Silverman LR, Demakos EP, Peterson BL, et al. Randomized controlled trial of azacitidine in patients with the myelodysplastic syndrome: a study of the cancer and leukemia group B. J Clin Oncol. 2002;20:2429–2440. - PubMed
    1. Silverman LR, McKenzie DR, Peterson BL, et al. Further analysis of trials with azacitidine in patients with myelodysplastic syndrome: studies 8421, 8921, and 9221 by the Cancer and Leukemia Group B. J Clin Oncol. 2006;24:3895–3903. - PubMed
    1. Fenaux P, Mufti GJ, Hellstrom-Lindberg E, et al. Efficacy of azacitidine compared with that of conventional care regimens in the treatment of higher-risk myelodysplastic syndromes: a randomised, open-label, phase III study. The lancet oncology. 2009;10:223–232. - PMC - PubMed
    1. Anderson JE, Appelbaum FR, Fisher LD, et al. Allogeneic bone marrow transplantation for 93 patients with myelodysplastic syndrome. Blood. 1993;82:677–681. - PubMed
    1. Zikos P, Van Lint MT, Frassoni F, et al. Low transplant mortality in allogeneic bone marrow transplantation for acute myeloid leukemia: a randomized study of low-dose cyclosporin versus low-dose cyclosporin and low-dose methotrexate. Blood. 1998;91:3503–3508. - PubMed

Publication types

MeSH terms