Myeloablative Versus Reduced-Intensity Hematopoietic Cell Transplantation for Acute Myeloid Leukemia and Myelodysplastic Syndromes
This research article has led to a Practice Changing Update on DynaMed Plus. It found that myeloablative conditioning increases relapse-free survival, but also increases treatment-related mortality compared to reduced intensity conditioning in patients with acute myeloid leukemia or myelodysplastic syndromes having first allogeneic hematopoietic cell transplantation
Allogeneic stem cell transplant (ASCT) with HLA matched donors is increasingly used for older patients with AML/MDS. It remains unclear if haploidentical transplantation (haploSCT) is a suitable option for older patients with this disease. We analyzed 43 patients with AML/MDS (median age 61 years) who underwent a haploSCT at our institution. All the patients received a fludarabine-melphalan-based reduced-intensity conditioning regimen and post-transplant cyclophosphamide-based GVHD prophylaxis. Except one patient who had early death, the remaining 42 patients (98%) engrafted donor cells.
Bone Marrow Transplantation, Published online: 11 September 2017; doi:10.1038/bmt.2017.171
Validation of the revised IPSS at transplant in patients with myelodysplastic syndrome/transformed acute myelogenous leukemia receiving allogeneic stem cell transplantation: a retrospective analysis of the EBMT chronic malignancies working party Bone Marrow Transplantation advance online publication, September 11 2017. doi:10.1038/bmt.2017.171 Authors: C Scheid, L de Wreede, A van Biezen, C Koenecke, G Göhring, L Volin, J Maertens, J Finke, J Passweg, D Beelen, J J Cornelissen, M Itälä-Remes, P Chevallier, N Russell, E Petersen, N Milpied, C Richard Espiga, A Peniket, J Sierra, G Mufti, C Crawley, J H Ve...
Rationale: Myeloid sarcoma (MS) and leukemia cutis (LC) are extramedullary tumors comprising myeloid blasts. They can occur de novo or concurrently with hematological disorders, usually acute myeloid leukemia (AML). AML chemotherapy is generally the initial therapy for MS and LC, and hematopoietic stem cell transplantation (HSCT) can be considered as additional therapy. However, treatment for older patients who are unable to continue intensive chemotherapy is not currently standardized. Patient concerns: A 71-year-old Japanese woman was diagnosed with multiple MSs associated with myelodysplastic syndrome (MDS), using bone...
Allogeneic hematopoietic stem cell transplantation (AHSCT) is a successful treatment modality for AML and MDS. Information on transplant outcomes among older patients is limited because of concern of adverse transplant-related mortality (TRM) and poor overall survival (OS).
Post-transplant relapse remains a major cause of treatment failure in patients with myelodysplastic syndromes (MDS) or acute myeloid leukemia (AML). Understanding of the biology of relapse and response to azacitidine treatment remains limited.
In this study, we evaluated trends and outcomes of allogeneic hematopoietic cell transplantation (HCT) in adults ≥70 years with hematologic malignancies across the United States. Adults ≥70 years with a hematologic malignancy undergoing first allogeneic HCT in the United States between 2000 and 2013 and reported to the Center for International Blood and Marrow Transplant Research were eligible. Transplant utilization and transplant outcomes, including overall survival (OS), progression-free survival (PFS), and transplant-related mortality (TRM) were studied. One thousand one hundred and six patients ≥70 years unde...
Hematopoietic stem cell transplantation (HSCT) is considered the gold standard for treatment of hematologic malignancies, including Fanconi anemia (FA), a cancer-prone disease with extremely high incidence of myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML). However, eradication of residual leukemia stem cells (LSCs), which often contributes to relapse, remains the challenge for HSCT. Here we investigate the interaction between leukemic mesenchymal niche and donor hematopoietic stem progenitor cells (HSPCs) by modeling FA HSCT.
The number of allogeneic hematopoietic stem cell transplantations (allo-HCTs) performed each year with curative intent for older adults with acute myelogenous leukemia (AML) or myelodysplastic syndrome (MDS) has continued to rise over the past decade. Much of the progress in the use of allo-HCT in older adults is due to the use of reduced-intensity conditioning (RIC) regimens, which have allowed many older patients with AML or MDS to receive curative allo-HCT . Without RIC, these older patients would otherwise be unfit for allo-HCT because of the toxicity associated with myeloablative conditioning regimens.
The number of allogeneic transplants performed each year with curative intent for older adults with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS) continued to rise during the past decade. Much of the progress in the use of alloHCT in older adults is due to reduced-intensity conditioning (RIC) regimens, which have allowed many older patients with AML or MDS to receive curative allogeneic hematopoietic cell transplantation (alloHCT).1 Without RIC, these older patients would otherwise be unfit for alloHCT because of the toxicities of myeloablative conditioning.