¹EA1638 Université Paris 6, Acute Leukemia Working Party and European Group of Blood and Marrow Transplant Office Paris, Paris, France

Correspondence: Dr V Rocha, Acute Leukemia Working Party–European Group of Blood and Marrow Transplant, Hôpital Saint-Louis and Hôpital Saint-Antoine, Université de Paris 7 and Université de Paris 6, 27, Rue de Chaligny, 75012 Paris, France; E-mail: vanderson.rocha@sls.ap-hop-paris.fr

²Other authors are listed in the Appendix

Received 30 May 2005; Accepted 23 August 2005; Published online 29 September 2005.

Abstract

Results of reduced intensity conditioning regimen (RIC) in the HLA identical haematopoietic stem cell transplantation (HSCT) setting have not been compared to those after myeloablative (MA) regimen HSCT in patients with acute myeloblastic leukaemia (AML) over 50 years of age. With this aim, outcomes of 315 RIC were compared with 407 MA HSCT recipients. The majority of RIC was fludarabine-based regimen associated to busulphan (BU) (53%) or low-dose total body irradiation (24%). Multivariate analyses of outcomes were used adjusting for differences between both groups. The median follow-up was 13 months. Cytogenetics, FAB classification, WBC count at diagnosis and status of the disease at transplant were not statistically different between the two groups. However, RIC patients were older, transplanted more recently, and more frequently with peripheral blood allogeneic stem cells as compared to MA recipients. In multivariate analysis, acute GVHD (II–IV) and transplant-related mortality were significantly decreased (P=0.01 and P<10^-4, respectively) and relapse incidence was significantly higher (P=0.003) after RIC transplantation. Leukaemia-free survival was not statistically different between the two groups. These results may set the grounds for prospective trials comparing RIC with other strategies of treatment in elderly AML.