Universität zu Köln

Heinicke, Thomas, Labopin, Myriam, Schmid, Christoph, Polge, Emmanuelle, Socie, Gerard, Blaise, Didier, Mufti, Ghulam J., Huynh, Anne, Brecht, Arne, Ledoux, Marie-Pierre, Cahn, Jean Yves, Milpied, Noel, Scheid, Christof, Hicheri, Yosr, Mohty, Mohamad, Savani, Bipin N. and Nagler, Arnon (2018). Reduced Relapse Incidence with FLAMSA-RIC Compared with Busulfan/Fludarabine for Acute Myelogenous Leukemia Patients in First or Second Complete Remission: A Study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation. Biol. Blood Marrow Transplant., 24 (11). S. 2224 - 2233. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1523-6536

Full text not available from this repository.

Abstract

Busulfan/fludarabine (BuFlu) is a widely used conditioning regimen for patients with myeloid malignancies. The sequential FLAMSA (fludarabine + Ara-C + amsacrine chemotherapy) protocol followed by either cyclophosphamide and total body irradiation (FLAMSA-TBI) or cyclophosphamide and busulfan (FLAMSA-Bu) has shown remarkable activity in high-risk acute myelogenous leukemia (AML) patients. Here we compare the outcomes of AML patients transplanted in first complete remission (CR1) or second complete remission (CR2) after conditioning with BuFlu or FLAMSA. Eligible patients had their first allogeneic stem cell transplantation for AML in CR1 or CR2 between January 2005 and June 2016. Donors were matched related or unrelated with up to 1 mismatch. Conditioning consisted of either BuFlu or FLAMSA. Propensity score matching was applied and comparisons were performed using weighted Cox regression. BuFlu conditioning was used in 1197 patients, whereas FLAMSA-TBI and FLAMSA-Bu were used in 258 and 141 patients, respectively. Median follow-up of survivors was 24.72 months. In univariate analysis, relapse incidence (RI) was 30.3%, 21.9%, and 23.1% in the BuFlu, FLAMSA-TBI, and FLAMSA-Bu groups, respectively (P < .01), and nonrelapse mortality at 2 years was 16.1%, 16.4%, and 26.7%, respectively (P < .01). Leukemia-free survival (LFS) at 2 years was 53.6%, 61.6%, and 50.1%, respectively (P = .03). Weighted Cox regression revealed that FLAMSA-TBI compared with BuFlu was associated with lower RI (hazard ratio [HR], .64; 95% confidence interval [CI], .42 to .98; P = .04) and a trend for better LFS (HR, .72; 95% CI, .49 to 1.06; P = .09). These results suggest that compared with BuFlu, conditioning with FLAMSA-TBI leads to reduced RI at 2 years in AML patients transplanted in CR1 or CR2. (C) 2018 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Heinicke, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Labopin, Myriam UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmid, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Polge, Emmanuelle UNSPECIFIED UNSPECIFIED UNSPECIFIED Socie, Gerard UNSPECIFIED UNSPECIFIED UNSPECIFIED Blaise, Didier UNSPECIFIED UNSPECIFIED UNSPECIFIED Mufti, Ghulam J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Huynh, Anne UNSPECIFIED UNSPECIFIED UNSPECIFIED Brecht, Arne UNSPECIFIED UNSPECIFIED UNSPECIFIED Ledoux, Marie-Pierre UNSPECIFIED UNSPECIFIED UNSPECIFIED Cahn, Jean Yves UNSPECIFIED UNSPECIFIED UNSPECIFIED Milpied, Noel UNSPECIFIED UNSPECIFIED UNSPECIFIED Scheid, Christof UNSPECIFIED UNSPECIFIED UNSPECIFIED Hicheri, Yosr UNSPECIFIED UNSPECIFIED UNSPECIFIED Mohty, Mohamad UNSPECIFIED UNSPECIFIED UNSPECIFIED Savani, Bipin N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Nagler, Arnon UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-166533
DOI:	10.1016/j.bbmt.2018.07.007
Journal or Publication Title:	Biol. Blood Marrow Transplant.
Volume:	24
Number:	11
Page Range:	S. 2224 - 2233
Date:	2018
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1523-6536
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language STEM-CELL TRANSPLANTATION; ACUTE MYELOID-LEUKEMIA; BUSULFAN DOSE INTENSITY; VERSUS-HOST-DISEASE; HIGH-RISK; CONDITIONING REGIMEN; SEQUENTIAL REGIMEN; ADULT PATIENTS; AML; INTERMEDIATE Multiple languages Hematology; Immunology; Transplantation Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/16653