RIC versus MAC UCBT in adults with AML

Nonrelapse mortality (NRM) is the first cause of treatment failure after unrelated cord blood transplantation (UCBT) following myeloablative conditioning (MAC). In the last decade, reduced-intensity conditioning (RIC) regimens have been developed with the aim of reducing NRM and allowing older patie...

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Detalles Bibliográficos
Autores: Baron, Frederic|||0000-0002-2944-3812, Ruggeri, Annalisa|||0000-0002-7261-2765, Beohou, Eric, Labopin, Myriam|||0000-0003-4514-4748, Sanz, Guillermo|||0000-0002-2767-8191, Milpied, Noel|||0000-0002-5177-014X, Michallet, Mauricette, Bacigalupo, Andrea, Blaise, Didier|||0000-0002-5684-9447, Malouf Sierra, Jorge|||0000-0001-5185-520X, Socié, Gérard|||0000-0002-2114-7533, Cornelissen, Jan J., Schmid, Christoph, Giebel, Sebastian, Gorin, Norbert-Claude, Esteve Reyner, Jordi|||0000-0002-8056-648X, Ciceri, Fabio|||0000-0003-0873-0123, Savani, Bipin|||0000-0002-3304-9965, Mohty, Mohamad|||0000-0002-7264-808X, Gluckman, Eliane, Nagler, Arnon
Tipo de recurso: artículo
Fecha de publicación:2016
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:289627
Acceso en línea:https://ddd.uab.cat/record/289627
https://dx.doi.org/urn:doi:10.18632/oncotarget.9599
Access Level:acceso abierto
Palabra clave:AML
Myeloablative
Reduced-intensity
Transplantation
Unrelated cord blood
Descripción
Sumario:Nonrelapse mortality (NRM) is the first cause of treatment failure after unrelated cord blood transplantation (UCBT) following myeloablative conditioning (MAC). In the last decade, reduced-intensity conditioning (RIC) regimens have been developed with the aim of reducing NRM and allowing older patients and those with medical comorbidities to benefit from UCBT. The aim of the current retrospective study was to compare transplantation outcomes of acute myeloid leukemia (AML) patients given UCBT after either RIC or MAC. Data from 894 adults with AML receiving a single or double UCBT as first allograft from 2004 to 2013 at EBMT centers were included in this study. 415 patients were given UCBT after RIC while 479 patients following a MAC. In comparison to MAC recipients, RIC recipients had a similar incidence of neutrophil engraftment and of acute and chronic graft-versus-host disease (GVHD). However, RIC recipients had a higher incidence of disease relapse and a lower NRM, translating to comparable leukemia-free (LFS), GVHD-free, relapse-free survival (GRFS) and overall survival (OS). These observations remained qualitatively similar after adjusting for differences between groups in multivariate analyses. In conclusion, these data suggest that LFS and OS are similar with RIC or with MAC in adults AML patients transplanted with UCBT. These observations could serve as basis for a future prospective randomized study.