Research output: Contribution to journal › Article › peer-review
Victoria T. Potter, Pramila Krishnamurthy, Linda D. Barber, ZiYi Lim, Michelle Kenyon, Robin M. Ireland, Hugues de Lavallade, Abdel Dhouri, Judith C.W. Marsh, Robert Marcus, Stephen Devereux, Aloysius Ho, Tony Pagliuca, Ghulam J. Mufti
Original language | English |
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Pages (from-to) | 111-117 |
Number of pages | 7 |
Journal | BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION |
Volume | 20 |
Issue number | 1 |
Early online date | 8 Nov 2013 |
DOIs | |
Accepted/In press | 22 Oct 2013 |
E-pub ahead of print | 8 Nov 2013 |
Published | Jan 2014 |
Long term outcomes of Alemtuzumab POTTER Accepted 22Oct2013 Epub 8Nov2013 GOLD VoR CCBYNCND
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Uploaded date:27 Jan 2020
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Licence:CC BY-NC-ND
Allogeneic hematopoietic stem cell transplantation (HSCT) with reduced-intensity conditioning (RIC) offers a potential cure for patients with myelodysplastic syndrome (MDS) who are ineligible for standard-intensity regimens. Previously published data from our institution suggest excellent outcomes at 1 yr using a uniform fludarabine, busulfan, and alemtuzumab-based regimen. Here we report long-term follow-up of 192 patients with MDS and acute myelogenous leukemia (AML) secondary to MDS (MDS-AML) transplanted with this protocol, using sibling (n = 45) or matched unrelated (n = 147) donors. The median age of the cohort was 57 yr (range, 21 to 72 yr), and median follow-up was 4.5 yr (range, 0.1 to 10.6 yr). The 5-yr overall survival (OS), event-free survival, and nonrelapse mortality were 44%, 33%, and 26% respectively. The incidence of de novo chronic graft-versus-host disease (GVHD) was low at 19%, illustrating the efficacy of alemtuzumab for GVHD prophylaxis. Conversely, the 5-yr relapse rate was 51%. For younger patients (age 60 yr having a 5-yr OS of 15% and relapse rate of 66%. Patients receiving preemptive donor lymphocyte infusions had an impressive 5-yr OS of 67%, suggesting that this protocol may lend itself to the incorporation of immunotherapeutic strategies. Overall, these data demonstrate good 5-yr OS for patients with MDS and MDS-AML undergoing alemtuzumab-based RIC-HSCT. The low rate of chronic GVHD is encouraging, and comparative studies with other RIC protocols are warranted.
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