Reduced intensity conditioning for acute myeloid leukemia using melphalan- vs busulfan-based regimens: a CIBMTR report-Reference-Cited by-同舟云学术

Reduced intensity conditioning for acute myeloid leukemia using melphalan- vs busulfan-based regimens: a CIBMTR report

Published:2020-07-14 Issue:13 Volume:4 Page:3180-3190
ISSN:2473-9529
Container-title:Blood Advances
language:en
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Author:

Zhou Zheng¹^ORCID,Nath Rajneesh²,Cerny Jan³^ORCID,Wang Hai-Lin⁴,Zhang Mei-Jie⁴⁵,Abdel-Azim Hisham⁶,Agrawal Vaibhav⁷^ORCID,Ahmed Gulrayz⁸^ORCID,Al-Homsi A. Samer⁹,Aljurf Mahmoud¹⁰,Alkhateeb Hassan B.¹¹,Assal Amer¹²^ORCID,Bacher Ulrike¹³^ORCID,Bajel Ashish¹⁴,Bashir Qaiser¹⁵^ORCID,Battiwalla Minocher¹⁶,Bhatt Vijaya Raj¹⁷,Byrne Michael¹⁸,Cahn Jean-Yves¹⁹,Cairo Mitchell²⁰,Choe Hannah²¹,Copelan Edward²²,Cutler Corey²³,Damlaj Moussab B.²⁴,DeFilipp Zachariah²⁵^ORCID,De Lima Marcos²⁶^ORCID,Diaz Miguel Angel²⁷,Farhadfar Nosha²⁸,Foran James²⁹,Freytes César O.³⁰^ORCID,Gerds Aaron T.³¹^ORCID,Gergis Usama³²,Grunwald Michael R.²²,Gul Zartash³³,Hamadani Mehdi⁴^ORCID,Hashmi Shahrukh³⁴³⁵^ORCID,Hertzberg Mark³⁶,Hildebrandt Gerhard C.³⁷^ORCID,Hossain Nasheed³⁸,Inamoto Yoshihiro³⁹,Isola Luis⁴⁰,Jain Tania⁴¹^ORCID,Kamble Rammurti T.⁴²,Khan Muhammad Waqas⁴³,Kharfan-Dabaja Mohamed A.⁴⁴,Kebriaei Partow¹⁵,Kekre Natasha⁴⁵^ORCID,Khera Nandita⁴⁶,Lazarus Hillard M.⁴⁷^ORCID,Liesveld Jane L.⁴⁸,Litzow Mark⁴⁹^ORCID,Liu Hongtao⁵⁰^ORCID,Marks David I.⁵¹,Martino Rodrigo⁵²^ORCID,Mathews Vikram⁵³^ORCID,Mishra Asmita⁵⁴,Murthy Hemant S.⁴⁴,Nagler Arnon⁵⁵⁵⁶,Nakamura Ryotaro⁵⁷^ORCID,Nathan Sunita⁵⁸,Nishihori Taiga⁵⁴^ORCID,Olin Rebecca⁵⁹,Olsson Richard F.⁶⁰⁶¹^ORCID,Palmisiano Neil⁶²,Patel Sagar S.⁶³^ORCID,Patnaik Mrinal M.¹¹,Pawarode Attaphol⁶⁴,Perales Miguel-Angel⁶⁵,Politikos Ioannis⁶⁵,Popat Uday¹⁵^ORCID,Rizzieri David⁶⁶,Sandmaier Brenda M.⁶⁷^ORCID,Savani Bipin N.⁶⁸,Seo Sachiko⁶⁹,Shah Nirav N.⁷⁰,Uy Geoffrey L.⁷¹^ORCID,Valcárcel David⁷²,Verdonck Leo F.⁷³,Waller Edmund K.⁷⁴^ORCID,Wang Youjin⁷⁵,Weisdorf Daniel⁷⁶^ORCID,Wirk Baldeep⁷⁷,Wong Eric¹⁴,Yared Jean A.⁷⁸^ORCID,Saber Wael⁴

Affiliation:

1. Beth Israel Lahey Health, Lahey Hospital and Medical Center, Burlington, MA;

2. Banner MD Anderson Cancer Center, Gilbert, AZ;

3. Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA;

4. Center for International Blood and Marrow Transplant Research, Department of Medicine, and

5. Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI;

6. Division of Hematology, Oncology and Blood & Marrow Transplantation, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, CA;

7. Division of Hematology-Oncology, Indiana University School of Medicine, Indianapolis, IN;

8. Internal Medicine, Medical College of Wisconsin, Milwaukee, WI;

9. New York University Langone Medical Center, New York, NY;

10. Department of Oncology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia;

11. Bone Marrow Transplant Program, Mayo Clinic, Rochester, MN;

12. NYPH/Columbia University Medical Center, New York, NY;

13. Department of Hematology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland;

14. Royal Melbourne Hospital City Campus, Parkville, VIC, Australia;

15. Department of Stem Cell Transplantation & Cellular Therapy, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX;

16. Sarah Cannon Blood Cancer Network, Nashville, TN;

17. The Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE;

18. Vanderbilt University Medical Center, Nashville, TN;

19. Department of Hematology, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France;

20. Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Department of Pediatrics, New York Medical College, Valhalla, NY;

21. The Ohio University Wexner Medical Center, James Comprehensive Cancer Center, Columbus, OH;

22. Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, NC;

23. Center for Hematologic Oncology, Dana-Farber Cancer Institute, Boston, MA;

24. King Abdulaziz Medical City; King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia;

25. Blood and Marrow Transplant Program, Massachusetts General Hospital, Boston, MA;

26. Department of Medicine, Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland, OH;

27. Department of Hematology/Oncology, Hospital Infantil Universitario Niño Jesus, Madrid, Spain;

28. Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, FL;

29. Bone Marrow Transplant Program, Mayo Clinic, Jacksonville, FL;

30. Texas Transplant Institute, San Antonio, TX;

31. Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH;

32. Hematologic Malignancies & Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY;

33. University of Cincinnati Medical Center, Cincinnati, OH;

34. Department of Internal Medicine, Mayo Clinic, Rochester, MN;

35. Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia;

36. Department of Haematology, Prince of Wales Hospital, Randwick, NSW, Australia;

37. Markey Cancer Center, University of Kentucky, Lexington, KY;

38. Stem Cell Transplant Program, Division of Hematology/Oncology, Department of Medicine, Loyola University Chicago Stritch School of Medicine, Maywood, IL;

39. Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan;

40. Mount Sinai Medical Center, New York, NY;

41. Memorial Sloan Kettering Cancer Center, New York, NY;

42. Division of Hematology and Oncology, Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX;

43. Bone Marrow Transplant Program, Division of Hematology/Oncology, Louisiana State University, Baton Rouge, LA;

44. Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL;

45. The Ottawa Hospital Blood & Marrow Transplant Program, Ottawa, Canada;

46. Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ;

47. Case Western Reserve University, Cleveland, OH;

48. Department of Medicine, University of Rochester Medical Center, Rochester, NY;

49. Division of Hematology and Transplant Center, Mayo Clinic Rochester, Rochester, MN;

50. University of Chicago Medicine, Chicago, IL;

51. Adult Bone Marrow Transplant, University Hospitals Bristol NHS Trust, Bristol, United Kingdom;

52. Divison of Clinical Hematology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain;

53. Christian Medical College Hospital, Vellore, India;

54. Department of Blood & Marrow Transplant and Cellular Immunotherapy (BMT CI), Moffitt Cancer Center, Tampa, FL;

55. Hematology Division and BMT, Chaim Sheba Medical Center, Tel Hashomer, Israel;

56. Division of Hematology and Bone Marrow Transplantation and Cord Blood Bank, Tel Aviv University, Tel Aviv, Israel;

57. Department of Hematology & Hematopoietic Cell Transplantation, City of Hope, Duarte, CA;

58. Rush University Medical Center, Chicago, IL;

59. University of California San Francisco, San Francisco, CA;

60. Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden;

61. Centre for Clinical Research Sormland, Uppsala University, Uppsala, Sweden;

62. Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA;

63. Blood and Marrow Transplant Program, University of Utah, Salt Lake City, UT;

64. Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Department of Internal Medicine, The University of Michigan Medical School, Ann Arbor, MI;

65. Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY;

66. Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC;

67. Division of Medical Oncology, University of Washington and Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA;

68. Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN;

69. Department of Haematology and Oncology, Dokkyo Medical University, Tochigi, Japan;

70. Department of Medicine, Medical College of Wisconsin, Milwaukee, WI;

71. Division of Oncology, Washington University School of Medicine, St. Louis, MO;

72. Department of Hematology, Hospital Vall d'Hebron, Barcelona, Spain;

73. Department of Hematology/Oncology, Isala Clinic, Zwolle, The Netherlands;

74. Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, GA;

75. National Cancer Institute, National Institutes of Health, Rockville, MD;

76. Division of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, MN;

77. Bone Marrow Transplant Program, Penn State Cancer Institute, Hershey, PA; and

78. Blood & Marrow Transplantation Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD

Abstract

Abstract There is a lack of large comparative study on the outcomes of reduced intensity conditioning (RIC) in acute myeloid leukemia (AML) transplantation using fludarabine/busulfan (FB) and fludarabine/melphalan (FM) regimens. Adult AML patients from Center for International Blood and Marrow Transplant Research who received first RIC allo-transplant between 2001 and 2015 were studied. Patients were excluded if they received cord blood or identical twin transplant, total body irradiation in conditioning, or graft-versus-host disease (GVHD) prophylaxis with in vitro T-cell depletion. Primary outcome was overall survival (OS), secondary end points were leukemia-free survival (LFS), nonrelapse mortality (NRM), relapse, and GVHD. Multivariate survival model was used with adjustment for patient, leukemia, and transplant-related factors. A total of 622 patients received FM and 791 received FB RIC. Compared with FB, the FM group had fewer transplant in complete remission (CR), fewer matched sibling donors, and less usage of anti-thymocyte globulin or alemtuzumab. More patients in the FM group received marrow grafts and had transplantation before 2005. OS was significantly lower within the first 3 months posttransplant in the FM group (hazard ratio [HR] = 1.82, P < .001), but was marginally superior beyond 3 months (HR = 0.87, P = .05). LFS was better with FM compared with FB (HR = 0.89, P = .05). NRM was significantly increased in the FM group during the first 3 months of posttransplant (HR = 3.85, P < .001). Long-term relapse was lower with FM (HR = 0.65, P < .001). Analysis restricted to patients with CR showed comparable results. In conclusion, compared with FB, the FM RIC showed a marginally superior long-term OS and LFS and a lower relapse rate. A lower OS early posttransplant within 3 months was largely the result of a higher early NRM.

Publisher

American Society of Hematology

Subject

Hematology

Link

http://ashpublications.org/bloodadvances/article-pdf/4/13/3180/1810861/advancesadv2019001266.pdf

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