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Reduced-intensity conditioning allogeneic hematopoietic cell transplantation for patients with hematologic malignancies who relapse following autologous transplantation: a multi-institutional prospective study from the Cancer and Leukemia Group B (CALGB trial 100002).

Publication ,  Journal Article
Bashey, A; Owzar, K; Johnson, JL; Edwards, PS; Kelly, M; Baxter-Lowe, L-A; Devine, S; Farag, S; Hurd, D; Ball, E; McCarthy, P; Lister, J ...
Published in: Biol Blood Marrow Transplant
April 2011

We prospectively treated 80 patients with relapse of malignancy or secondary myelodysplasia after autologous hematopoietic cell transplantation (AHCT) with allogeneic HCT (allo-HCT) using a reduced-intensity conditioning regimen of fludarabine 150 mg/m(2) plus intravenous busulfan 6.4 mg/kg. Both matched sibling (MSD) and unrelated donors (MUD) were allowed. Patients transplanted from MUD donors received more intensive graft-versus-host disease (GVHD) prophylaxis, including rabbit antithymocyte globulin (ATG) 10 mg/kg, mycophenolate mofetil, and an extended schedule of tacrolimus. With a median follow-up of 3.1 years (0.9-5.8), treatment-related mortality (TRM) at 6 months and 2 years was 8% and 23%, respectively. Neither TRM nor the rates of acute GVHD (aGVHD) were different in those with sibling or MUD donors. Donor CD3 cell chimerism >90% at day +30 was achieved more often in patients with MUD than with matched sibling donors, 70% versus 23% (P < .0001). Median event-free suvival was higher in patients who achieved early full donor chimerism (14.2 versus 8 months, P = .0395). Allo-HCT using this reduced-intensity conditioning regimen can be performed with low TRM in patients who have received a prior AHCT. Efforts to improve early donor CD3 chimerism may improve event-free survival.

Duke Scholars

Published In

Biol Blood Marrow Transplant

DOI

EISSN

1523-6536

Publication Date

April 2011

Volume

17

Issue

4

Start / End Page

558 / 565

Location

United States

Related Subject Headings

  • Transplantation, Homologous
  • Transplantation, Autologous
  • Transplantation Conditioning
  • Survival Rate
  • Recurrence
  • Rabbits
  • Prospective Studies
  • Middle Aged
  • Male
  • Immunology
 

Citation

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Bashey, A., Owzar, K., Johnson, J. L., Edwards, P. S., Kelly, M., Baxter Lowe, L. A., … Linker, C. (2011). Reduced-intensity conditioning allogeneic hematopoietic cell transplantation for patients with hematologic malignancies who relapse following autologous transplantation: a multi-institutional prospective study from the Cancer and Leukemia Group B (CALGB trial 100002). Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation, 17(4), 558–565. https://doi.org/10.1016/j.bbmt.2010.07.015
Bashey, A., K. Owzar, J. L. Johnson, P. S. Edwards, M. Kelly, L. A. Baxter Lowe, S. Devine, et al. “Reduced-intensity conditioning allogeneic hematopoietic cell transplantation for patients with hematologic malignancies who relapse following autologous transplantation: a multi-institutional prospective study from the Cancer and Leukemia Group B (CALGB trial 100002).Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation 17, no. 4 (April 2011): 558–65. https://doi.org/10.1016/j.bbmt.2010.07.015.
Bashey A, Owzar K, Johnson JL, Edwards PS, Kelly M, Baxter Lowe LA, et al. Reduced-intensity conditioning allogeneic hematopoietic cell transplantation for patients with hematologic malignancies who relapse following autologous transplantation: a multi-institutional prospective study from the Cancer and Leukemia Group B (CALGB trial 100002). Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation. 2011 Apr;17(4):558–65.
Bashey, A., et al. “Reduced-intensity conditioning allogeneic hematopoietic cell transplantation for patients with hematologic malignancies who relapse following autologous transplantation: a multi-institutional prospective study from the Cancer and Leukemia Group B (CALGB trial 100002).Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation, vol. 17, no. 4, Apr. 2011, pp. 558–65. Manual, doi:10.1016/j.bbmt.2010.07.015.
Bashey A, Owzar K, Johnson JL, Edwards PS, Kelly M, Baxter Lowe LA, Devine S, Farag S, Hurd D, Ball E, McCarthy P, Lister J, Shea TC, Linker C. Reduced-intensity conditioning allogeneic hematopoietic cell transplantation for patients with hematologic malignancies who relapse following autologous transplantation: a multi-institutional prospective study from the Cancer and Leukemia Group B (CALGB trial 100002). Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation. 2011 Apr;17(4):558–565.
Journal cover image

Published In

Biol Blood Marrow Transplant

DOI

EISSN

1523-6536

Publication Date

April 2011

Volume

17

Issue

4

Start / End Page

558 / 565

Location

United States

Related Subject Headings

  • Transplantation, Homologous
  • Transplantation, Autologous
  • Transplantation Conditioning
  • Survival Rate
  • Recurrence
  • Rabbits
  • Prospective Studies
  • Middle Aged
  • Male
  • Immunology