Faculty Collaboration Database

Comparison of non-myeloablative conditioning regimens for lymphoproliferative disorders. Bone Marrow Transplant 2015 Mar;50(3):367-74

Date

12/02/2014

Pubmed ID

25437248

Pubmed Central ID

PMC4351124

DOI

10.1038/bmt.2014.269

Scopus ID

2-s2.0-84938416290 (requires institutional sign-in at Scopus site)   9 Citations

Abstract

Hematopoietic cell transplantation (HCT) with non-myeloablative (NMA) conditioning for lymphoproliferative diseases (LD) includes fludarabine with and without low-dose TBI. Transplant outcomes were compared among patients aged ⩾40 years with LD who received a HCT with TBI (N=382) or no-TBI (N=515) NMA from 2001 to 2011. The groups were comparable except for donor, graft, prophylaxis for GVHD, disease status and year of HCT. Cumulative incidences of grades II-IV GVHD at 100 days were 29% and 20% (P=0.001) and of chronic GVHD at 1 year were 54% and 44% (P=0.004) for TBI and no-TBI, respectively. Multivariate analysis of progression/relapse, treatment failure and mortality showed no outcome differences by conditioning. Full donor chimerism at day 100 was observed in 82% vs 64% in the TBI and no-TBI groups, respectively (P=0.006). Subsets of the four most common conditioning/GVHD prophylaxis combinations demonstrated higher rates of grades II-IV acute (P<0.001) and chronic GVHD (P<0.001) among recipients of TBI-mycophenolate mofetil (MMF) compared with other combinations. TBI-based NMA conditioning induces faster full donor chimerism, but overall survival outcomes are comparable to no-TBI regimens. Combinations of TBI and MMF are associated with higher rates of GVHD without impact on survival outcomes in patients with LD.

Author List

Hong S, Le-Rademacher J, Artz A, McCarthy PL, Logan BR, Pasquini MC

Authors

Brent R. Logan PhD Director, Professor in the Institute for Health and Equity department at Medical College of Wisconsin
Marcelo C. Pasquini MD, MS Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Cohort Studies
Disease-Free Survival
Female
Hematopoietic Stem Cell Transplantation
Humans
Lymphoma
Male
Middle Aged
Transplantation Conditioning
Treatment Outcome
Whole-Body Irradiation