Original scientific paper
Treatment of acute myeloid leukemia using reduced intensity conditioning – method reserved for elderly patients only?
Nadira Duraković
; Zavod za hematologiju, Klinika za unutarnje bolesti, KBC Zagreb, Zagreb, Hrvatska
Ranka Serventi-Seiwerth
; Zavod za hematologiju, Klinika za unutarnje bolesti, KBC Zagreb, Zagreb, Hrvatska
Mirta Mikulić
; Zavod za hematologiju, Klinika za unutarnje bolesti, KBC Zagreb, Zagreb, Hrvatska
Zina Perić
; Zavod za hematologiju, Klinika za unutarnje bolesti, KBC Zagreb, Zagreb, Hrvatska
Boris Labar
; Zavod za hematologiju, Klinika za unutarnje bolesti, KBC Zagreb, Zagreb, Hrvatska
Abstract
Aim: The aim of this article was to present the results achieved using this method in our center, as well as to expand the knowledge of potentially great benefit that reduced conditioning is bringing in the treatment of patients with acute myeloid leukemia and myelodisplastic syndrome. Methods: From March 2008 until December 2010, a total of 10 patients were transplanted, median age was 53.5 years (range 35.3 – 58.3). Four patients were previously transplanted, three received autologous and one patient allogeneic bone marrow transplantation. All patients received conditioning consisting of fludarabine and busulphan. For Graft-versus-Host Disease (GVHD) prophylaxis they received cyclosporine, with or without Mycophenolate mofetil, and in case of unrelated donor ATG was given prior to transplantation. All of the patients received grafts consisting of peripheral hematopoietic stem cells. Results: Cumulative incidence of acute GVHD was 30 % for grade I-IV, and 20 % for grade III-IV; for chronic GVHD it was 10 %. Overall survival was 20 %; disease-free survival was 22 %. Discussion: Comparing our results with so far published series, our group has notably lower overall survival rate and somewhat higher incidence of GVHD. Considering the small number of patients in our group, direct comparison was not possible. Even though this method was designed for older group of patients, recently published data shows that this method is suitable for younger patients as well, but randomized studies on larger number of patients are still needed. Conclusion: Ten patients with acute myeloid leukemia or myelodisplastic syndrome were treated in our center using reduced intensity conditioning. Even though achieved results are not as good as those so far reported, a proper analysis is still not possible due to the small number of our patients.
Keywords
acute myeloid leukemia; GVHD; reduced intensity conditioning
Hrčak ID:
76669
URI
Publication date:
1.12.2011.
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