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Tytuł pozycji:

Intermediate intensity conditioning regimen containing FLAMSA, treosulfan, cyclophosphamide, and ATG for allogeneic stem cell transplantation in elderly patients with relapsed or high-risk acute myeloid leukemia.

Tytuł:
Intermediate intensity conditioning regimen containing FLAMSA, treosulfan, cyclophosphamide, and ATG for allogeneic stem cell transplantation in elderly patients with relapsed or high-risk acute myeloid leukemia.
Autorzy:
Chemnitz JM; BMT Program, Department I of Internal Medicine, University of Cologne, Kerpener Straße 62, 50924 Köln, Germany. />von Lilienfeld-Toal M
Holtick U
Theurich S
Shimabukuro-Vornhagen A
Krause A
Brossart P
Hallek M
Scheid C
Źródło:
Annals of hematology [Ann Hematol] 2012 Jan; Vol. 91 (1), pp. 47-55. Date of Electronic Publication: 2011 May 17.
Typ publikacji:
Journal Article
Język:
English
Imprint Name(s):
Publication: Berlin : Springer Verlag
Original Publication: Berlin ; New York : Springer International, c1991-
MeSH Terms:
Antilymphocyte Serum/*therapeutic use
Antineoplastic Agents, Alkylating/*therapeutic use
Busulfan/*analogs & derivatives
Cyclophosphamide/*therapeutic use
Hematopoietic Stem Cell Transplantation/*methods
Immunosuppressive Agents/*therapeutic use
Leukemia, Myeloid, Acute/*therapy
Transplantation Conditioning/*methods
Adult ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Busulfan/therapeutic use ; Disease-Free Survival ; Female ; Humans ; Leukemia, Myeloid, Acute/prevention & control ; Male ; Middle Aged ; Recurrence ; Transplantation, Homologous/methods ; Whole-Body Irradiation/adverse effects
Substance Nomenclature:
0 (Antilymphocyte Serum)
0 (Antineoplastic Agents, Alkylating)
0 (Immunosuppressive Agents)
8N3DW7272P (Cyclophosphamide)
CO61ER3EPI (treosulfan)
G1LN9045DK (Busulfan)
Entry Date(s):
Date Created: 20110518 Date Completed: 20120223 Latest Revision: 20131121
Update Code:
20240104
DOI:
10.1007/s00277-011-1253-9
PMID:
21584670
Czasopismo naukowe
Lower dosage of total body irradiation (TBI) and chemotherapy in reduced-intensity conditioning (RIC) regimens prior to allogeneic stem cell transplantation have reduced the toxicity of the conditioning and non-relapse mortality. The FLAMSA-RIC protocol for high-risk patients with acute myeloid leukemia (AML) and myelodysplastic syndrome has shown promising results in refractory disease as well as in first complete remission. Still, the RIC protocol containing 4 Gy TBI/cyclophosphamide/anti-thymocyte globulin (ATG) implicates acute toxicity mainly due to TBI preventing its usage in patients with advanced age and/or severe co-morbidities. To increase feasibility and safety of the conditioning, we substituted TBI with treosulfan. Seventeen patients with relapsed or high-risk AML and either advanced age or concomitant disease were treated within a preparative regimen containing a 4-day course of chemotherapy (FLAMSA) followed by RIC comprising of treosulfan, cyclophosphamide, and ATG. After median follow-up of 12 months, the estimated incidences of relapse and non-relapse mortality were 25% and 20%, respectively. One-year overall survival was 62%. In conclusion, FLAMSA-treosulfan/cyclophosphamide/ATG is an intermediate intensity conditioning regimen with acceptable non-relapse mortality for patients with relapsed or high-risk AML. Substituting TBI with treosulfan provides an alternative to treat elderly patients or patients with severe co-morbidities when TBI appears not feasible due to the potential of increased toxicity.

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