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Reduced intensity versus myeloablative allogeneic stem cell transplantation for the treatment of acute myeloid leukemia, myelodysplastic syndrome and acute lymphoid leukemia.

Publication ,  Journal Article
Horwitz, ME
Published in: Curr Opin Oncol
March 2011

PURPOSE OF REVIEW: Use of a reduced intensity conditioning (RIC) regimen has now become standard practice among older or more infirmed stem cell transplantation candidates. Encouraging outcome in this population has led to the question of whether RIC should replace standard myeloablative conditioning (MAC) regimens. This review will summarize the available outcomes data comparing RIC and MAC approaches to stem cell transplantation in adult patients with acute myeloid leukemia, myelodysplastic syndrome (MDS) and acute lymphoid leukemia. RECENT FINDINGS: There are currently no completed prospective randomized controlled studies comparing outcomes of RIC to MAC. The best insight into differences in outcome comes from large registry-based retrospective studies. These studies demonstrate that the use of RIC is associated with a reduction in transplant-related mortality but an increased risk of disease relapse. As a result, for patients undergoing stem cell transplantation in remission, disease free and overall survival are similar. SUMMARY: The current retrospective data provide justification for the use of RIC regimens in all adult stem cell transplant candidates with acute leukemia in remission and MDS. More definitive conclusions regarding differences between the MAC and RIC approach to stem cell transplantation await results of ongoing prospective randomized trials.

Duke Scholars

Published In

Curr Opin Oncol

DOI

EISSN

1531-703X

Publication Date

March 2011

Volume

23

Issue

2

Start / End Page

197 / 202

Location

United States

Related Subject Headings

  • Stem Cell Transplantation
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma
  • Oncology & Carcinogenesis
  • Myelodysplastic Syndromes
  • Leukemia, Myeloid, Acute
  • Humans
  • 3211 Oncology and carcinogenesis
  • 1112 Oncology and Carcinogenesis
 

Published In

Curr Opin Oncol

DOI

EISSN

1531-703X

Publication Date

March 2011

Volume

23

Issue

2

Start / End Page

197 / 202

Location

United States

Related Subject Headings

  • Stem Cell Transplantation
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma
  • Oncology & Carcinogenesis
  • Myelodysplastic Syndromes
  • Leukemia, Myeloid, Acute
  • Humans
  • 3211 Oncology and carcinogenesis
  • 1112 Oncology and Carcinogenesis