We conducted a retrospective registry-based analysis to compare the outcome of 361 allogeneic human leukocyte antigen (HLA)-identical peripheral blood stem cell transplants (PBSCT) with reduced intensity conditioning (RIC) to that of 1369 autologous (auto) PBSCT in patients aged 50 years or older with de novo acute myeloid leukemia (AML), performed from 1997 until 2003 and reported to the European Group for Blood and Marrow Transplantation. Median age was 58 and 57 years in the RIC and auto groups, respectively. RIC patients had more advanced disease at the time of transplant. At a median follow-up of 24 months for RIC and 16 months for auto, multivariate analysis showed a lower risk for relapse (RR 0.77, P=0.013) without increased non-relapse mortality (NRM) in RIC patients (RR 1.26, P=0.28). Moreover, leukemia-free survival (RR 1.22, P=0.02) and overall survival (OS) (RR 1.32, P=0.005) were superior in the RIC group. In patients in 1st (CR), fewer relapses were counterbalanced by significantly increased NRM. Therefore, there was no survival advantage in this subgroup. In patients in 2nd or subsequent CR, LFS and OS were superior in the RIC group. RIC transplants show encouraging results in this older patient population with de novo AML.
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List of participating centres with three or more RIC patients included:
Institut Paoli Calmettes, Marseille, France, D Blaise; CHU Bordeaux Hôpital Haut-Lévèque, Pessac, France, N Milpied; University of Leipzig, Leipzig, Germany, D Niederwieser; Hôpital A Michallon, Grenoble, France, JY Cahn; University Hospital Brno, Brno, Czech republic, J Mayer; Medizinische Klinik und Poliklinik, Ulm, Germany, D Bunjes; Sahlgrenska University Hospital, Goeteborg, Sweden, M Brune; University Hospital, Basel, Switzerland, A Gratwohl; University Hospital, Zürich, Switzerland, U Schanz; Medizinische Universitaet Wien, Vienna, Austria, H Greinix; Manchester Royal Infirmary, Manchester, UK, J Liu Yin; University Hospital Eppendorf, Hamburg, Germany, AR Zander; GKT School of Medicine King's Denmark Hill Campus, London, UK, GJ Mufti; Cliniques Universitaires St-Luc, Brussels, Belgium, A Ferrant; Hôpital Henri Mondor, Créteil, France, C Cordonnier; Hadassah University Hospital, Jerusalem, Israel, S Slavin; University Hospital Innsbruck, Innsbruck, Austria, G Gastl; Ospedale V Cervello, Palermo, Italy, R Scimè; University Hospital, Linköping, Sweden, N Theorin; Chaim Sheba Medical Centre, Tel-Hashomer, A Nagler; Plymouth Hospitals NHS Trust Derriford Hospital, Plymouth, UK, MD Hamon; University Medical centre, Utrecht, The Netherlands, LF Verdonck; Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam, The Netherlands, JJ Cornelissen; Hotel Dieu, Nantes, France, JL Harousseau; Hospital Santa Creu I Sant Pau, Barcelona, Spain, J Sierra; Ospedale di Careegi, Firenze, Italy, A Bossi; Heinrich Heine Universität, Düsseldorf, Germany, G Kobbe; Hopital de Purpan, Toulouse, France, M Attal; Hôpital E Herriot, Lyon, France, M Michallet; Hopital Hautepierre, Strasbourg, France, B Lioure; Hospital Clínico, Salamanca, Spain, D Caballero; St. Bartholomew's and The Royal London Hospital West Smithfield, London, UK, J Gribben; Universitaetsklinikum Dresden, Dresden, Germany, G Ehninger; University of Freiburg, Freiburg, Germany, J Finke; HSS Antonio e Biagio, Alessandria, Italy, B Allione; Hotel Dieu, Paris, France, B Rio; Azienda Ospedaliera S Giovanni, Torino, Italy, M Falda; Hopital Jean Minjoz, Besançon, France, E Deconinck; St. James Hospital Trinity College, Dublin, Ireland, S McCann; Ospedale Niguarda Ca'Granda, Milano, Italy, S Siena; Policlinico San Matteo, Pavia, Italy, EP Alessandrino; Hannover Medical university, Hannover, Germany, B Hertenstein; Goethe-Universität Medizinische Klinik II, Frankfurt, Germany, D Hoelzer; University of Wales, Cardiff, UK, K Wilson; Policlinico Le Scotte, Siena, Italy, F Lauria; University Hospital Maastricht, Maastricht, The Netherlands, H Schouten; Institute of Hematology and Blood Transfusion, Prague, Czech Republic, A Vitek; Institut Gustave Roussy, Villejuif, France, JH Bourhis; University of Münster, Münster, Germany, J Kienast; Charles University Hospital, Pilsen, Czech Republic, V Koza; K Marcinkowski University of Medical Science, Pozna, Poland, M Komarnicki; Umea University Hospital, Umea, Sweden, A Wahlin; University of Saarland, Homburg, Germany, J Schubert; Charité Universitätsmedizin Berlin, Berlin, Germany, R Arnold.
List of participating centres with seven or more auto patients included:
Institut Paoli Calmettes, Marseille, France, D Blaise; Royal Marsden Hospital, London, UK, M Potter; Kliniken Essen Süd, Essen, Germany, W Heit; Cardarelli Hospital, Napoli, Italy, F Ferrara; Hôpital E Herriot, Lyon, France, M Michallet; University La Sapienza, Rome, Italy, R Foa; CHU Bordeaux Hôpital Haut-Lévèque, Pessac, France, N Milpied; Robert-Bosch-Krankenhaus, Stuttgart, Germany, S Martin; Hospital Clinic, Institute of Hematology and Oncology, Barcelona, Spain, E Carreras; Hotel Dieu, Paris, France, B Rio; Spedali Civili-Brescia, Brescia, Italy, G Rossi; Hannover Medical university, Hannover, Germany, B Hertenstein; Heinrich Heine Universität, Klinik für Hämat, Düsseldorf, Germany, G Kobbe; Hospital Universitario La Fe, Valencia, Spain, MA Sanz; Johannes-Gutenberg University, Mainz, Germany, K Kolbe; Universitaetsklinikum Dresden, Dresden, Germany, G Ehninger; Rambam Medical Center, Haifa, Israel, JM Rowe; Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland, A Rosselet; Hospital U Marqués de Valdecilla, Santander, Spain, A Iriondo Atienza; VU university Medical centre, Amsterdam, The Netherlands, GJ Ossenkoppele; Charles University Hospital, Hradec Králové, Czech Republic, L Jebavy; Hotel Dieu, Nantes, France, JL Harousseau; Medical University Graz, Graz, Austria, W Linkesch; Leiden University Hospital, Leiden, The Netherlands, R Willemze; Medizinische Klinik und Poliklinik, Ulm, Germany, D Bunjes; Karolinska University Hospital, Stockholm, Sweden, O Ringden; Christie NHS Trust Hospital, Manchester, UK, E Liakopoulou; Hospital Santa Creu I Sant Pau, Barcelona, Spain, J Sierra; University Tor Vergata, St Eugenio Hospital, Rome, Italy, W Arcese; University medical Centre St Radboud, Nijmejen, A Scattenberg; Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam, The Netherlands, JJ Cornelissen; Hopital de Purpan, Toulouse, France, M Attal; Azienda Ospedali Riuniti di Ancona, Ancona (Torrette), Italy, A Olivieri; Cliniques Universitaires St. Luc, Brussels, Belgium, A Ferrant; Hospital Reina Sofia, Córdoba, Spain, A Torres-Gomez; Kantonsspital Aarau, Aarau, Switzerland, M Bargetzi; Hospedale Nord Taranto Italy, P Mazza; ULB - Hopital Erasme, Brussels, Belgium, W Feremans; Klinikum Nürnberg, Nürnberg, Germany, H Wandt; S Bortolo Hospital Vicenza, Italy, F Rodeghiero; University Hospital Gasthuisberg, Leuven, Belgium, J Maertens; University Hospital Bern, Bern, Switzerland, K Leibundgut; University Hospital Center Rebro, Zagreb, Croatia, B Labar; AZ Stuivenberg, Antwerp, Belgium, P Zachée; Medisch Spectrum Twente, Enschede, The Netherlands, MR Schaafsma; Hospital Universitari Germans Trias i Pujol, Barcelona, Spain, JM Ribera Santasusana; Royal Perth Hospital, Perth, Australia, RP Herrmann; Hopital Saint Antoine, Paris, France, NC Gorin; Ospedale di Niguarda Ca Granda, Milano, Italy, E Morra; Hospital San Maurizio, Bolzano, Italy, P Coser; University Hospital, Olomouc, Czech Republic, K Indrák; Charité - Campus Benjamin Franklin, Berlin, Germany, L Uharek; Ege University Medical School, Bornova-Izmir, Turkey, S Cagirgan; Charles University Hospital, Pilsen, Czech Republic, V Koza.
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Herr, AL., Labopin, M., Blaise, D. et al. HLA-identical sibling allogeneic peripheral blood stem cell transplantation with reduced intensity conditioning compared to autologous peripheral blood stem cell transplantation for elderly patients with de novo acute myeloid leukemia. Leukemia 21, 129–135 (2007). https://doi.org/10.1038/sj.leu.2404461
- reduced intensity conditioning
- peripheral blood stem cell transplantation
- acute myeloid leukemia
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