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GvHD-free, relapse-free survival after reduced-intensity allogeneic hematopoietic cell transplantation in older patients with myeloid malignancies

Bone Marrow Transplantation volume 51, pages 1642–1643 (2016)Cite this article

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Hematopoietic cell transplantation (HCT) remains the only curative option for the majority of patients with myeloid malignancies.1 The main risk factors associated with HCT are either due to transplant-related mortality and morbidity that include acute and chronic GvHD or relapse.1, 2, 3 These risks increase with patient age and comorbidities.4 The median age of diagnosis for patients with myeloid malignancies is above 65 years and HCT strategies that use reduced-intensity conditioning regimens (RIC) now allow HCT in older patients with AML and myelodysplastic syndrome (MDS).5, 6, 7 The main principle of these approaches is to decrease regimen-related toxicities by relying mainly on the GvL effect rather than high-dose chemotherapy that kills malignant cells. Although RIC regimens may be associated with lower transplant-related mortality and morbidity, a higher incidence of relapse-related mortality has been observed.5, 6, 7 Thus, identifying older patients with AML or MDS that will have the utmost benefit from HCT remains clinically challenging.

Recently, a composite end point of GvHD-free, relapse-free survival (GRFS) at 1 year after HCT was proposed as a reliable end point that can account for transplant- and relapse-related mortalities and morbidities.8, 9 Prior studies have shown that the probability of GRFS among adult and younger patients with myeloid malignancies is ~23–31% in the first year post HCT, but the probability of this end point in older adults who are undergoing RIC HCT is unknown.8, 9 In this study, we investigated the rate of GRFS at 1 year after RIC HCT in older patients with AML and MDS.

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Authors and Affiliations

  1. Department of Hematology and Oncology, Blood and Marrow Transplant Program, Cleveland Clinic, Taussig Cancer Institute, Cleveland, OH, USA

    A Nazha, L Rybicki, D Abounader, B Bolwell, R Dean, A T Gerds, D Jagadeesh, B K Hamilton, B T Hill, M Kalaycio, H Liu, B Pohlman, R Sobecks, M A Sekeres & N S Majhail

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  1. A Nazha
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  2. L Rybicki
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  3. D Abounader
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  4. B Bolwell
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  6. A T Gerds
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  7. D Jagadeesh
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  8. B K Hamilton
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  10. M Kalaycio
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  11. H Liu
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  12. B Pohlman
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  13. R Sobecks
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  14. M A Sekeres
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  15. N S Majhail
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Correspondence to A Nazha.

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Nazha, A., Rybicki, L., Abounader, D. et al. GvHD-free, relapse-free survival after reduced-intensity allogeneic hematopoietic cell transplantation in older patients with myeloid malignancies. Bone Marrow Transplant 51, 1642–1643 (2016). https://doi.org/10.1038/bmt.2016.254

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