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Stem Cell Transplantation (SCT)

Comparative outcome of reduced intensity and myeloablative conditioning regimen in HLA identical sibling allogeneic haematopoietic stem cell transplantation for patients older than 50 years of age with acute myeloblastic leukaemia: a retrospective survey from the Acute Leukemia Working Party (ALWP) of the European group for Blood and Marrow Transplantation (EBMT)

Leukemia volume 19, pages 2304–2312 (2005)Cite this article

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.

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Acknowledgements

We thank all data managers from EBMT and National registries who collect, check and contribute data for the ALWP.

Author information

Author notes

  1. M Aoudjhane, M Labopin, N C Gorin, A Shimoni, T Ruutu, H-J Kolb, F Frassoni, J M Boiron, J L Yin, J Finke, H Shouten, D Blaise, M Falda, A A Fauser, J Esteve, E Polge, S Slavin, D Niederwieser, A Nagler and V Rocha: Other authors are listed in the Appendix

Authors and Affiliations

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

    M Aoudjhane, M Labopin, N C Gorin, A Shimoni, T Ruutu, H-J Kolb, F Frassoni, J M Boiron, J L Yin, J Finke, H Shouten, D Blaise, M Falda, A A Fauser, J Esteve, E Polge, S Slavin, D Niederwieser, A Nagler & V Rocha

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on behalf of the Acute Leukemia Working Party of EBMT

Corresponding author

Correspondence to V Rocha.

Appendix

Appendix

List of EBMT transplant centres contributing data for this study:

CIC:: 119: Galieni P, Mazzoni Hospital Haematology Service Ascoli Piceno, Italy

132: Petrini M, Dipartimento di Oncologia, dei trapianti e delle nuove tecnologie in medicina Divisione di Ematologia, Pisa, Italy

152: Schlimok G, II Medizinische Klinik, Postfach 10 19 20, Augsburg, Germany

160: Buzyn A, Hôpital Necker Service Hematologie Adulte, Paris, France

170: Ovali E, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey

202: Gratwohl A, Division of Hematology Kantonsspital, Basel, Switzerland

203: Willemze R, BMT Centre Leiden Leiden University Hospital, Leiden, The Netherlands

204: Bunjes D, Abteilung Innere Medizin III Medizinische Klinik und Poliklinik, Ulm, Germany

205: Goldman JM, Department of Haematology Hammersmith Hospital at London, United Kingdom

206: Jacobsen N, BMT Unit Department of Hematology L 4042 Blegdamsvey 9, Copenhagen, Denmark

207: Gluckman E, Deptartmentof Hematology – BMT – Hopital St Louis, Paris, France

208: Schanz U, Department of Medicine, University Hospital, Zurich, Switzerland

209: Boogaerts MA, Department of Hematology, University Hospital, Gasthuisberg, Leuven, Belgium

212: Ljungman P, Department of Hematology, Huddinge University Hospital, Huddinge, Sweden

214: Montserrat E, Institute of Hematology & Oncology, Department of Hematology, Hospital Clinic, Barcelona, Spain

215: Bron D, Experimental Hematology Institut Jules Bordet, Brussels, Belgium

216: Potter M, Department of Hematology, Royal Free Hospital and School of Med., London, United Kingdom

217: Bacigalupo A, Department of Hematology, Ospedale San Martino, Genova, Italy

218: Powles R, Leukaemia Myeloma Units Royal Marsden Hospital, Sutton, United Kingdom

222: Rio B, Service d'Hematologie Hotel Dieu, Paris, France

223: Kanz L, Medizinische Klinik Abteilung II, Tübingen, Germany

224: Goldstone AH, Department of Haematology, University College London Hospital, London, United Kingdom

225: Remes K, Turku University Central Hospital BMT Unit, Department of Medicine,Turku, Finland

227: Greinix HT, AKH und Universitaetskliniken Wien Klink fuer Innere I, Vienna, Austria

228: Davies JM, Department of Hematology, Western General Hospital, Edinburgh, United Kingdom

230: Blaise D, Institut Paoli Calmettes. 232 Boulevard de Ste. Marguerite, Marseille, France

231: Falda M, Centro Trapianti Midollo Azienda Ospedaliera S. Giovanni, Torino, Italy

232: Mandelli F, Dipartimento di Biotecnologie Cellulari e Ematologia, University ‘La Sapienza’, Rome, Italy

233: Cahn JY, Service d'Hématologie Hopital, Jean Minjoz Besancon, France

234: Ferrant A, Department of Haematology, Cliniques Universitaires St. Luc, Brussels, Belgium

235: Brinch L, Department of Medicine, Rikshospitalet, Oslo, Norway

236: Fernández-Ranada JM, Department of Hematology, Hospital de la Princesa, Madrid, Spain

238: Torres Gomez A, Department of Hematology, Córdoba Hospital, Córdoba, Spain

239: Verdonck LF, University Medical Centre, Department of Haematology, Utrecht, The Netherlands

240: Baccarani M, Institute of Hematology and Medical Oncology Serágnoli, Hospital San Orsola, Bologna, Italy

242: Iriondo A, Hospital Universitario ‘Marqués de Valdecilla’, Santander, Spain

244: Franklin I, Department of Medicine, Glasgow Royal Infirmary, Glasgow, United Kingdom

245: Rizzoli V, Cattedra di Ematologia – University of Parma Centro Trapianti Midollo Osseo, Parma, Italy

246: Cornelissen JJ, Erasmus MC-Daniel den Hoed Cancer Centre, PO Box 5201 Rotterdam The Netherlands

247, Van den Berg H, Academisch Ziekenhuis bij deUniversiteit van Amsterdam, Emma Kinderziekenhuis, Amsterdam, The Netherlands

252: Cordonnier C, Sve d' Hematologie Hôpital Henri Mondor, Creteil, France

253: Harousseau JL, Department de Hematologie Hotel Dieu, Nantes, France

254: Barnard DL, Bone Marrow Transplant Unit Level 8, Gledhow Wing, Leeds, United Kingdom

255: Littlewood T, Clinical Haematology, The Oxford Radcliffe Hospital, Oxford, United Kingdom

256: Horst HA, BMT University/Department of Internal Med. II Christian-Albrechts-University, Kiel, Germany

257: McCann S, Department of Hematology, St James Hospital Trinity College, Dublin, Ireland (Rep)

258: Slavin S, Department of Bone Marrow Transplantation, Hadassah University Hospital, Jerusalem, Israel

259: Schaefer UW, Department of Bone Marrow Transplantation, University Hospital, Essen, Germany

260: Sierra J, Clinical Hematology, Division Hospital Santa Creu i Sant Pau, Barcelona, Spain

261: Chapuis B, Division d'Hématologie, Hopital Cantonal Universitaire, Geneva, Switzerland

262: Leblond V, Pitie-Salpetriere 47, boulevard de l'Hopital, Paris, France

264: Guilhot F, Clinical Hematology, Head of the Bone Marrow Transplant Unit, Poitiers, France

265: Lambertenghi Deliliers G, Ospedale Maggiore di Milano IRCCS, Milano, Italy

266: Simonsson B, Department of Medicine, University Hospital, Uppsala, Sweden

267: Reiffers J, CHU Bordeaux Hôpital Haut-leveque, Pessac, France

270: Sotto JJ, Department of Hematology Hopital A Michallon, Grenoble, France

271: Gastl G, University Hospital Innsbruck, Division of Hematology and Oncology, Innsbruck, Austria

273: Bay JO, Fédération de Greffe de Moelle et de Thérapie Cellulaire d'Auvergne, Clermont-Ferrand, France

276: Jackson GL, Department of Hematology, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom

282: García-Conde J, Hospital Clínico Universitario Servicio de Hematologia y Oncologia, Valencia, Spain

283: Lenhoff S, Department of Hematology, University Hospital, Lund, Sweden

286: Alessandrino EP, Department of Hematology, BMT unit Policlinico San Matteo, Pavia, Italy

287: Majolino I, Department of Hematology and BMT Ospedale S Camillo-Forlanini, Rome, Italy

288: Izzi T, Department of Medicine Spedali Civili – Brescia, Brescia, Italy

289: Brune M, Center for Hematopoietic Cell Transplantation (CHECT), Goeteborg, Sweden

291: Pimentel P, Inst. Portugues Oncologia Centro do Porto – BMT Unit, Porto, Portugal

293: Siegert W, Campus Charité Mitte Medizinische Klinik und Poliklinik II, Berlin, Germany

294: Morra E, Hematology Department, Ospedale di Niguarda Ca' Granda, Milano, Italy

295: Hertenstein B, Department of Hematology/Oncology Medical School of Hannover, Hannover, Germany

297: Hoelzer D, Department Hematology, Zentrum Inn Medizin, Universität Frankfurt, Frankfurt, Germany

299: Coser P, Department of Hematology – BMT Unit Hospital San Maurizio, Bolzano, Italy

300: Abecasis M, Inst. Portugues Oncologia, BMT Unit, Lisboa, Portugal

302: Labar B, Department of Medicine/BMT Unit (Haematology), University Hospital Centre – Rebro, Zagreb, Croatia

303: Burnett AK, Department of Haematology, College of Medicine, Cardiff, United Kingdom

304: Bosi A, BMT Unit, Department of Hematology, Ospedale di Careggi, Firenze, Italy

307: Leone G, Istituto Semeiotica Medica, Ematologia Universita Cattolica S Cuore, Rome, ITALY

308: Linkesch W, Karl-Franzens-University-Graz Department of Internal Medicine, Graz, Austria

311: Schwerdtfeger R, Deutsche Klinik für Diagnostik KMT Zentrum, Wiesbaden, Germany

321: Lauria F, Department of Hematology, Policlinico Le Scotte, Siena, Italy

331: Martinelli G, European Institute of Oncology, Milano, Italy

332: Mazza P, Institute of Haematology Hospedale, Nord Taranto, Italy

339: Zachée P, AZ Stuivenberg Lange Beeldekensstraat, 267 Antwerp, Belgium

344: Culligan DJ, Grampian University Hospitals Trust, Department of Haematology, Aberdeen, United Kingdom

345: Rowe JM, Department of Hematology & BMT Rambam Medical Center, Haifa, Israel

372: Arpaci F, GATA BMT Center, Gülhane Military Medical Academy, Ankara, Turkey

374: De Souza CA, University Est. de Campinas/TMO/UNICAMP Cidade Universitaria ‘Zeferino Vaz’, Campinas, Brazil

378: Saglio G, Ospedale San Luigi Orbassano Medicina Interna II SEZ 5A, Torino, Italy

387: Craddock C, Department of Haematology, University Hospital Birmingham, NHS Trust, Birmingham, United Kingdom

389: Niederwieser D, University Leipzig, Division of Internal Med. II, Dapartment of Haematology/Oncology, Leipzig, Germany

390: Haas R, Klinik für Hämat, Onkol, Klin. Immun. Heinrich Heine Universität, Düsseldorf, Germany

392: Scimè R, Div. di Ematologia e Unità Trapianti Ospedale V. Cervello, Palermo, Italy

501: Clark RE, Royal Liverpool University Hospital, Department of Haematology, Liverpool, United Kingdom

504: Poros A, Department Hematol & BMT Unit National Medical Centre, Budapest, Hungary

513: Kolb HJ, Med. Klinik III Klinikum Grosshadern, München, Germany

515: Ruutu T, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland

523: Gratecos N, Hematologie Clinique Hôpital de l'ARCHET I, Nice, France

524: Ho AD, University of Heidelberg Medizinische Klinik u. Poliklinik V, Heidelberg, Germany

526: Carella AM, IRCCS, Casa Sollievo della Sofferenza Unit of Hematology and San Giovanni, Rotondo, Italy

529: Visani G, Department of Hematology, Pesaro Hospital, Pesaro, Italy

530: Doelken G, Medizinische Universitätsklinik C Ernst-Moritz-Arndt-Univer. Greifswald, Greifswald, Germany

539: Marsh JCW, Department of Cellular & Molecular Sciences St George's Hospital, Medical School, London, United Kingdom

544: Pogliani EM, University di Milano-Bicocca Ospedale S. Gerardo, Monza, Italy

558: Peschel C, III Med Klinik der TU Klinkum Rechts der Isar, München, Germany

561: Fassas A, Haematology Department/BMT Unit, The George Papanicolaou General, Thessaloniki, Greece

565: Schouten H, Department Internal Med. Hematology/Oncology, University Hospital Maastricht, Maastricht, The Netherlands

566: Marcus R, Department of Haematology, Addenbrookes Hospital, Box 234, Cambridge, United Kingdom

574: Indrák K, Department of Haemato-oncology University Hospital, Olomouc, Czech Repub

587: Iacopino P, Azienda Ospedaliera Bianchi-Melacrino-Morelli Reggio, Calabria, Italy

588: Ossenkoppele GJ, Free University Hospital Amsterdam, Department of Hematology, BR 240 Amsterdam, The Netherlands

590: Knauf W, Innere Medizin/Hämatologie/Onkologie Klin. Benjamin Franklin, FU Berlin, Berlin, Germany

592: Fauser AA, Klinik für Knochenmarktransplantation und Hämatologie/Onkologie GmbH Idar-Oberstein, Germany

594: Lutz D, Elisabethinen-Hospital I. Internal Department, Linz, Austria

595: Schwarer AP, Alfred Hospital, BMT Programme Commercial RD, Melbourne, Australia

597: Vorlicek J, University Hospital Brno Department of Internal Med. – Hematooncology, Brno, Czech Repub

601: Liu Yin J, Manchester Royal Infirmary Haematology, Manchester

607: Ferrara F, Division of Hematology, Cardarelli Hospital, Napoli, Italy

610: Mistrik M, Clinic of Hematology & Transfusiology University Hospital, Bratislava, Slovakian Republic

612: Leon Lara A, Hospital del SAS Department of Hematology, Cádiz, Spain

613: Ribera Santasusana JM, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain

614: Zander AR, University Hospital Eppendorf Bone Marrow Transplantation Centre, Hamburg, Germany

617: Gurman G, Department of Hematology, Ankara University Medical School, Ankara, Turkey

622: Harhalakis N, Division of Hematology, BMT Unit Evangelismos Hospital, Athens, Greece

623: Benedetti F, Divisione di Ematologia, Unità di TMO Policlinico G.B. Rossi, Verona, Italy

624: Attal M, CHU Department Hematologie Hopital de Purpan, Toulouse, France

625: Wandt H, 5. Medizinische Klinik, BMT-Unit Klinikum Nürnberg, Nürnberg, Germany

640: Pretnar J, Department of Hematology University Med. Center, Ljubljana, Slovenia

645: Neubauer A, Klinik fuer Haematologie, Onkologie und Immunologie, Marburg, Germany

646: Demuynck H, Heilig Hartziekenhuis Hematology – Oncology Department, Roeselare, Belgium

650: Boasson M, Service des Maladies du Sang CHRU, Angers, France

656: Vitek A, Institute of Hematology and Blood Transfusion, Prague, Czech Repub

658: Barbui T, Divisione di Ematologia Ospedale Bergamo, Bergamo, Italy

660: Gugliotta L, Unita Operativa Ematologia Arcispedale S. Maria Nuova Reggio, Emilia, Italy

663: Sanz MA, Hospital Universitario La Fe Servicio de Hematologia, Valencia, Spain

666: Bourhis JH, BMT Unit, Hematology Division Institut Gustave, Roussy Villejuif Cedex, France

671: Michallet M, BMT Unit Pavillon E Hopital E. Herriot, Lyon, France

672: Lioure B, Onco-Hématologie Hopital de Hautepierre, Strasbourg, France

676: Bordigoni P, Médecine Infantile II Hopitaux de Barbois Enfants Vandoeuvre les, Nancy, France

680: Kienast J, Department of Hematol./Oncol. University of Münster, Münster, Germany

691: Dincer S, Ankara Numune Education and Research Hospital, Ankara, Turkey

692: Musso M, Ospedale La Maddalena – Dapartment Oncologico Unità Operativa di Oncoematologiae, Palermo, Italy

704: Orchard K, Haematology, Oncology, & Paediatrics Department of Haematology, Southampton, United Kingdom

710: Herrmann RP, Hematology Dept., BMT Unit Royal Perth Hospital, Wellington, St. Perth, Australia

713: Hunter AE, Department of Haematology, Leicester Royal Infirmary, Leicester, United Kingdom

717: Russell NH, Nottingham City Hospital, Hucknall Road, Nottingham, United Kingdom

718: Koza V, Department of Hematology/Oncology, Charles University Hospital, Pilsen, Czech Repub

722: Besalduch J, Hematology Service Hospital Universitari Son Dureta, Palma de Mallorca, Spain

725: Afanassiev BV, Department of BMT, Centre of Hematology SPb State I. Pavlov Medical University, St Petersburg, Russia

727: Caballero D, Servicio de Hematología Hospital Clínico Salamanca, Spain

728: Fernández MN, Clinica Puerta de Hierro Servicio de Hematologia y Hemoterapia, Madrid, Spain

729: Jebavy L, Charles University Hospital, Department of Clinical Hematology, Hradec Králové, Czech Repub

730: Komarnicki M, Department of Hematology K Marcinkowski University, Poznan, Poland

731: Wahlin A, Department of Internal Medicine, Umea University Hospital, Umea, Sweden

734: Martínez-Rubio AM, Hospital Infantil La Paz Hemato-Oncologia Madrid Spain

735: Moraleda Jimenez JM, Hospital Morales Meseguer Unidad de Trasplante de Médula Osea, Murcia, Spain

740: Juliusson G, Department of Hematology, University Hospital, Linköping, SWEDEN

744: Noens LA, Haematology and Bloodbank University Hospital Gent, Gent, Belgium

751: Efremidis A, Hellenic Cancer Institute, St Savvas Oncology Hospital, Athens, Greece

754: Nagler A, Department of Bone Marrow Transplantation, Tel-Aviv University, Tel-Hashomer, Israel

759: Grañena A, Department of Hematology, Institut Catala d'Oncologia, Barcelona, Spain

763: Mufti GJ, Department of Haematological Medicine, GKT School of Medicine, London, United Kingdom

766: Rotoli B, Division of Hematology, ‘Federico II’ Medical School, Napoli, Italy

778: Vora A, Haematology Department, Sheffield Children's Hospital, Sheffield, United Kingdom

780: Chopra R, Department of Haematology, Christie NHS Trust Hospital, Manchester, United Kingdom

785: Joerg S, Department of Internal Med., BMT Unit University of Saarland, Hamburg, Germany

786: Kolbe K, III. Medizinische Klinik und Poliklinik, Johannes-Gutenberg-University, Mainz, Germany

787: Andreesen R, Department of Hematology and Oncology University, Regensburg, Regensburg, Germany

788: Leoni P, Clinica di Ematologia Ospedale di Torrette, Ancona-Torrette, Italy

792: Milone G, Ospedale Ferrarotto Divisione Clinicizzata di Ematologia, Catania, Italy

797: Rodeghiero F, Department of Hematology S Bortolo Hospital, Vicenza, Italy

799: Hellmann A, BMT Unit, Department of Haematology, Medical University of Gdansk, Gdansk, Poland

807: Arnold R, Charit Campus, Virchow-Klinkum, Berlin, Germany

808: Ehninger G, Universitaetsklinikum Dresden Medizinische Klinik und Poliklinik I, Dresden, Germany

809: Gramatzki M, Division of Hematology/Oncology, Department of Medicine III, University Erlangen, Erlangen, Germany

810: Finke J, Department of Medicine – Hematology, Oncology University of Freiburg, Freiburg, Germany

813: Bregni M, Hematology and BMT Istituto Scientifico HS Raffaele, ilano, Italy

816: Rzepecki P, Bone Marrow Transplantation Unit, Military Medical Academy, Warsaw, Poland

819: Diez-Martin JL, Sección de Trasplante de Medula Osea Hospital GU Gregorio Maranon, Madrid, Spain

823: Hamon MD, Plymouth Hospitals, NHS Trust, Derriford Hospital, Plymouth, United Kingdom

825: Levis A, SS Antonio e Biagio e C Arrigo Haematology Department, Alessandria, Italy

941: Tilly H, Centre Henri Becquerel, Rouen, France

954: Wiktor-Jedrzejczak W, Department of Hematology & Oncology, The Medical University of Warsaw, Warsaw, Poland

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Aoudjhane, M., Labopin, M., Gorin, N. et al. Comparative outcome of reduced intensity and myeloablative conditioning regimen in HLA identical sibling allogeneic haematopoietic stem cell transplantation for patients older than 50 years of age with acute myeloblastic leukaemia: a retrospective survey from the Acute Leukemia Working Party (ALWP) of the European group for Blood and Marrow Transplantation (EBMT). Leukemia 19, 2304–2312 (2005). https://doi.org/10.1038/sj.leu.2403967

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