Background: Reduced intensity conditioning (RIC) protocols for allogeneic haemopoietic cell transplants (HCT) have become commonplace treatments for patients with haematological disease, extending allogeneic HCT to older and less fit patients. There is a perception that centres treating larger numbers of patients have improved outcomes.
Aims: We wanted to examine whether outcomes for adult allogeneic HCT patients from our smaller centre were equivalent to those expected at larger centres internationally.
Methods: Clinical and laboratory data were collected on all patients who received allogeneic HCT during 2000-2012. Outcomes, including overall survival (OS) and progression-free survival, were compared between patients receiving myeloablative conditioning (MAC) and RIC protocols.
Results: One hundred and eighteen adult patients underwent allogeneic HCT with MAC (n = 51) or RIC (n = 67). The mean age of patients receiving MAC (35.8 years, range 18-56) was lower than those receiving RIC (48.4 years, range 19-64). Two-year OS was similar for MAC and RIC patients (66% vs 62%, P = 0.17), whereas 2-year progression-free survival was superior in MAC patients (63% vs 50%, P = 0.01) due to fewer relapses. OS was reduced in older patients irrespective of conditioning. Patients with chronic graft-versus-host disease had improved survival due to fewer relapses. OS was unaffected by HCT comorbidity index, donor, cell source or patient/donor cytomegalovirus status.
Conclusion: RIC protocols have resulted in long-term survival in many patients ineligible for MAC protocols. In our smaller centre, patient age but not conditioning intensity influenced survival, which was equivalent to reports from larger centres.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/imj.12456 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Frailty assessment in adults undergoing allogeneic hematopoietic cell transplantation: insights from a multicenter GETH-TC study to optimize outcomes and care.
Front Immunol
January 2025
Institut Català d'Oncologia - Hospital Duran i Reynals, IDIBELL, Universitat de Barcelona, Barcelona, Spain.
Introduction: This multicenter prospective study sponsored by the (GETH-TC) explores the use of frailty assessments in allo-HCT candidates.
Methods: Frailty was measured using the HCT Frailty Scale at first consultation and HCT admission in 404 adults from 15 HCT programs in Spain. Based on the results, patients were classified into fit, pre-frail and frail categories.
Cardiovascular Complications of Immune Effector Cell Therapies in Pediatric Hematological and Solid Tumors.
Pediatr Blood Cancer
January 2025
Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA.
Background: Immune effector cell (IEC) therapies, including chimeric antigen receptor (CAR)-modified T-cell therapy, have shown efficacy in pediatric B-cell acute lymphoblastic leukemia (B-ALL) and are being investigated for other malignancies. A common toxicity associated with IEC therapy is cytokine release syndrome (CRS), which can lead to cardiovascular decompensation due to systemic inflammation. Data are limited regarding cardiovascular adverse effects in children.
View Article and Find Full Text PDFLow incidence of primary graft failure with bendamustine, fludarabine, and busulfan conditioning prior to haploidentical allogeneic hematopoietic cell transplantation.
Hematol Oncol Stem Cell Ther
January 2025
R.M. Gorbacheva Memorial Institute of Children Hematology and Transplantation, State Medical University Named I.P. Pavlov, Saint-Petersburg, Russian Federation.
The outcomes of haploidentical hematopoietic cell transplantation (haplo-HCT) have improved with the implication of new in vivo and ex vivo graft-versus-host disease (GVHD) prophylaxis regimens. However, primary graft failure is still reported more frequently in haplo-HCT compared to a matched donor HCT. We conducted a pilot study (NCT04942730) to evaluate the impact of adding bendamustine to fludarabine and busulfan conditioning on engraftment after haplo-HCT.
View Article and Find Full Text PDFRisk-adapted letermovir prophylaxis based on a scoring system predicting a higher burden of cytomegalovirus exposure after allogeneic hematopoietic cell transplantation.
Transplant Cell Ther
January 2025
Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan; Division of Hematology, Jichi Medical University, Shimotsuke, Japan. Electronic address:
We previously reported that the area under the curve of log-transformed cytomegalovirus antigenemia (CMV-AUC) until 100 days after allogeneic hematopoietic cell transplantation (allo-HCT) was associated with an increased risk of non-relapse mortality. We applied a risk-adapted letermovir (LTV) prophylaxis strategy guided by a risk score that predicts a higher CMV-AUC. First, we retrospectively analyzed 278 allo-HCT recipients between 2007 and 2017 (Period 1).
View Article and Find Full Text PDFReal-World Experience With Maribavir for Treatment of Refractory or Resistant Cytomegalovirus Infection in Hematopoietic Cell Transplant Recipients and Hematologic Malignancy Patients.
Transpl Infect Dis
January 2025
Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Background: Refractory and/or resistant (R/R) cytomegalovirus (CMV) infection is a serious complication after allogeneic hematopoietic cell transplantation (HCT). Maribavir, an oral antiviral agent, was approved in November 2021 for the treatment of R/R CMV in transplant recipients. However, real-world data on the use of maribavir in HCT recipients and hematologic malignancy (HM) patients are limited.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!