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Comparison of non-myeloablative conditioning regimens for lymphoproliferative disorders.

Publication ,  Journal Article
Hong, S; Le-Rademacher, J; Artz, A; McCarthy, PL; Logan, BR; Pasquini, MC
Published in: Bone Marrow Transplant
March 2015

Hematopoietic cell transplantation (HCT) with non-myeloablative (NMA) conditioning for lymphoproliferative diseases (LD) includes fludarabine with and without low-dose TBI. Transplant outcomes were compared among patients aged ⩾40 years with LD who received a HCT with TBI (N=382) or no-TBI (N=515) NMA from 2001 to 2011. The groups were comparable except for donor, graft, prophylaxis for GVHD, disease status and year of HCT. Cumulative incidences of grades II-IV GVHD at 100 days were 29% and 20% (P=0.001) and of chronic GVHD at 1 year were 54% and 44% (P=0.004) for TBI and no-TBI, respectively. Multivariate analysis of progression/relapse, treatment failure and mortality showed no outcome differences by conditioning. Full donor chimerism at day 100 was observed in 82% vs 64% in the TBI and no-TBI groups, respectively (P=0.006). Subsets of the four most common conditioning/GVHD prophylaxis combinations demonstrated higher rates of grades II-IV acute (P<0.001) and chronic GVHD (P<0.001) among recipients of TBI-mycophenolate mofetil (MMF) compared with other combinations. TBI-based NMA conditioning induces faster full donor chimerism, but overall survival outcomes are comparable to no-TBI regimens. Combinations of TBI and MMF are associated with higher rates of GVHD without impact on survival outcomes in patients with LD.

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Published In

Bone Marrow Transplant

DOI

EISSN

1476-5365

Publication Date

March 2015

Volume

50

Issue

3

Start / End Page

367 / 374

Location

England

Related Subject Headings

  • Whole-Body Irradiation
  • Treatment Outcome
  • Transplantation Conditioning
  • Middle Aged
  • Male
  • Lymphoma
  • Immunology
  • Humans
  • Hematopoietic Stem Cell Transplantation
  • Female
 

Citation

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Hong, S., Le-Rademacher, J., Artz, A., McCarthy, P. L., Logan, B. R., & Pasquini, M. C. (2015). Comparison of non-myeloablative conditioning regimens for lymphoproliferative disorders. Bone Marrow Transplant, 50(3), 367–374. https://doi.org/10.1038/bmt.2014.269
Hong, S., J. Le-Rademacher, A. Artz, P. L. McCarthy, B. R. Logan, and M. C. Pasquini. “Comparison of non-myeloablative conditioning regimens for lymphoproliferative disorders.Bone Marrow Transplant 50, no. 3 (March 2015): 367–74. https://doi.org/10.1038/bmt.2014.269.
Hong S, Le-Rademacher J, Artz A, McCarthy PL, Logan BR, Pasquini MC. Comparison of non-myeloablative conditioning regimens for lymphoproliferative disorders. Bone Marrow Transplant. 2015 Mar;50(3):367–74.
Hong, S., et al. “Comparison of non-myeloablative conditioning regimens for lymphoproliferative disorders.Bone Marrow Transplant, vol. 50, no. 3, Mar. 2015, pp. 367–74. Pubmed, doi:10.1038/bmt.2014.269.
Hong S, Le-Rademacher J, Artz A, McCarthy PL, Logan BR, Pasquini MC. Comparison of non-myeloablative conditioning regimens for lymphoproliferative disorders. Bone Marrow Transplant. 2015 Mar;50(3):367–374.

Published In

Bone Marrow Transplant

DOI

EISSN

1476-5365

Publication Date

March 2015

Volume

50

Issue

3

Start / End Page

367 / 374

Location

England

Related Subject Headings

  • Whole-Body Irradiation
  • Treatment Outcome
  • Transplantation Conditioning
  • Middle Aged
  • Male
  • Lymphoma
  • Immunology
  • Humans
  • Hematopoietic Stem Cell Transplantation
  • Female