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Reduced Intensity Conditioning

Elderly age and prior autologous transplantation have a deleterious effect on survival following allogeneic peripheral blood stem cell transplantation with reduced-intensity conditioning: results from the Spanish multicenter prospective trial

Bone Marrow Transplantation volume 33, pages 477–482 (2004)Cite this article

Summary:

Over a 3-year period, 145 patients ineligible for myeloablative conditioning underwent reduced-intensity conditioning (RIC) hematopoietic stem cell transplantation (SCT) from an HLA-identical sibling in a prospective study. The median age was 54 years, 88 patients were male and 61 patients were beyond the early-intermediate phase of their disease. The 100-day probability of developing grade II–IV acute graft-versus-host disease (GVHD) was 34%, and the 1-year probability of developing chronic extensive GVHD was 41%. The 1-year probabilities of transplant-related mortality (TRM), overall (OS) and progression-free survival were 20, 60 and 52%, respectively. Multivariate analyses found a better OS in: (i) patients <60 years; and (ii) recipients of a first SCT; and a higher TRM in: (i) age >60 years, (ii) recipients of a prior autologous SCT, and (iii) an ECOG performance status >1. The 1-year TRM in patients with 0 or 1 and >2 of the above-mentioned adverse prognostic factors were 17 vs 53%, respectively (P<0.001). In summary, our study shows that elderly patients have a higher TRM following an RIC protocol. However, age by itself should not preclude these RIC transplants, since TRM appears to be unacceptably high only in the presence of additional adverse factors.

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Authors and Affiliations

  1. Hematology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

    M Gómez-Núñez, R Martino, C Canals & J Sierra

  2. Hematology Department, Hospital Clínico de Salamanca, Spain

    M D Caballero, J A Pérez-Simón, M V Mateos & J S Miguel

  3. Hematology Department, Institut Català d'Oncologia, Spain

    J Sarrá

  4. Hematology Department, Hospital de Jérez, Spain

    A León

  5. Hematology Department, Hospital Clínico de Valencia, Spain

    C Solano

  6. Hematology Department, H Universitario de Murcia, Spain

    J M Moraleda

  7. Hematology Department, Hospital Clínic de Barcelona, Spain

    A Urbano-Ispizua

  8. Hematology Department, Hospital Son Dureta de Palma de Mallorca, Spain

    J Besalduch

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  1. M Gómez-Núñez
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  2. R Martino
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  3. M D Caballero
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  4. J A Pérez-Simón
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  13. J S Miguel
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  14. J Sierra
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Correspondence to R Martino.

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Gómez-Núñez, M., Martino, R., Caballero, M. et al. Elderly age and prior autologous transplantation have a deleterious effect on survival following allogeneic peripheral blood stem cell transplantation with reduced-intensity conditioning: results from the Spanish multicenter prospective trial. Bone Marrow Transplant 33, 477–482 (2004). https://doi.org/10.1038/sj.bmt.1704379

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