Kuzmina et al. (Abstract)
Cellular Therapy and Transplantation (CTT), Vol. 3, No. 9
doi: 10.3205/ctt-2010-No9-abstract03
© The Authors. This abstract is provided under the following license:
Creative Commons Attribution 3.0 Unported
Abstract accepted for "4th Raisa Gorbacheva Memorial Meeting on Hematopoietic Stem Cell Transplantation",
Saint Petersburg, Russia, September 18–20, 2010
Reduced-intensity allogeneic hematopoietic cell transplantation in patients older than 50 years
Larisa A. Kuzmina, Elena N. Parovichnikova, Irina A. Demidova, Lidia S. Lubimova, Natalia A. Petinati, Elena O. Gribanova, Valeriy G. Savchenko
National Haematologic Scientific Center, Russian Academy of Medical Sciences, Moscow, Russia
Correspondence: Larisa A. Kuzmina, National Haematologic Scientific Center, Russian Academy of Medical Sciences, Novozykovski pr., 4, 125167, Moscow, Russia; E-mail: Kuzlara@rambler.ru
Abstract
Aim: To analyze the results of allogeneic haematopoietic cell transplantation (allo-HCT) in patients older than 50 years.
Patients and methods: Fourteen patients with acute myeloid leukemia (AML) and high -risk myelodysplastic syndrome (MDS) underwent reduced-intensity allogeneic stem cell transplantation from HLA-identical sibling donors. All of them received conditioning with fludarabine and ATG. Their median age was 53 years (50–65); M/F 6/8. Five patients had increased blast counts in their bone marrow before allo-HCT, ranging from 10 to 34.8%.
Results: All patients quickly restored blood value. There was no conditioning-related mortality. Eight patients (57.1%) are alive in complete remission. The duration of the remission period lasts from 1 months to 85 months (median – 24.5 months). Five- year overall survival is 41.6%. Ten patients (71.4%) developed acute graft-versus-host disease (GVHD), 9 patients (64.3%) had stage II–IV. Chronic GVHD was diagnosed in 80% of the patients, who survived for 100 days after transplantation. Two patients with chronic GVHD died from infectious complications. Three (21%) patients relapsed, one had graft failure. These 4 patients died at different times after allo-HCT. They had mixed chimerism on the 30th day after HCT and acute GVHD.
Conclusion: reduced-intensity allo-HCT is acceptable and effective for patients older than 50 years, but it is often accompanied by GVHD development.
Keywords: allogeneic hematopoietic cell transplantation, reduced-intensity conditioning, acute myeloid leukemia, myelodysplastic syndrome, graft-versus-host disease
