TY - JOUR
T1 - Fludarabine-Melphalan Conditioning for AML and MDS
T2 - Alemtuzumab Reduces Acute and Chronic GVHD without Affecting Long-Term Outcomes
AU - Besien, Koen Van
AU - Kunavakkam, Rangesh
AU - Rondon, Gaby
AU - De Lima, Marcos
AU - Artz, Andrew
AU - Oran, Betul
AU - Giralt, Sergio
N1 - Funding Information:
Financial disclosure: This work was supported in part by an unrestricted grant from Berlex pharmaceuticals and by NCI Grant 1-R21 CA 101337-01. Dr. van Besien is partially supported by grant K24 CA116471.
PY - 2009/5
Y1 - 2009/5
N2 - The purpose of this study was to determine the effect of alemtuzumab on treatment-related mortality (TRM), relapse, overall survival (OS), and disease-free survival (DSF) in patients with acute myelogenous leukemia (AML) and myelodysplastic syndromes (MDS) undergoing reduced intensity conditioning (RIC). We compared the outcome of 95 patients treated at the University of Chicago with fludarabine melphalan (Flu + Mel) + alemtuzumab conditioning and 59 patients treated at the M.D. Anderson Cancer Center with Flu + Mel conditioning. Both groups had similar patient and donor characteristics. There were no significant differences in TRM, relapse, survival, and DFS between the 2 groups. The incidence of acute graft-versus-host disease (aGVHD) grade II-IV (relative risk [RR] 5.5, P < .01) and chronic GVHD (cGVHD) (RR 6.6, P < .01) were significantly lower in patients receiving alemtuzumab. The addition of alemtuzumab to an RIC regimen dramatically reduces the incidence of aGVHD and cGVHD in patients with AML and MDS undergoing allogeneic transplantation. TRM, relapse risk, OS and DFS are not affected.
AB - The purpose of this study was to determine the effect of alemtuzumab on treatment-related mortality (TRM), relapse, overall survival (OS), and disease-free survival (DSF) in patients with acute myelogenous leukemia (AML) and myelodysplastic syndromes (MDS) undergoing reduced intensity conditioning (RIC). We compared the outcome of 95 patients treated at the University of Chicago with fludarabine melphalan (Flu + Mel) + alemtuzumab conditioning and 59 patients treated at the M.D. Anderson Cancer Center with Flu + Mel conditioning. Both groups had similar patient and donor characteristics. There were no significant differences in TRM, relapse, survival, and DFS between the 2 groups. The incidence of acute graft-versus-host disease (aGVHD) grade II-IV (relative risk [RR] 5.5, P < .01) and chronic GVHD (cGVHD) (RR 6.6, P < .01) were significantly lower in patients receiving alemtuzumab. The addition of alemtuzumab to an RIC regimen dramatically reduces the incidence of aGVHD and cGVHD in patients with AML and MDS undergoing allogeneic transplantation. TRM, relapse risk, OS and DFS are not affected.
KW - AML
KW - Alemtuzumab
KW - Allogeneic transplant
KW - MDS
KW - T cell depletion
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U2 - 10.1016/j.bbmt.2009.01.021
DO - 10.1016/j.bbmt.2009.01.021
M3 - Article
C2 - 19361753
AN - SCOPUS:63749116929
SN - 1083-8791
VL - 15
SP - 610
EP - 617
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 5
ER -