Results In Different Disease Settings Myeloid malignancies

Or et al. reported results of a reduced-intensity conditioning regimen HCT in 24 CML patients in first chronic phase. Patients had a median age of 35 (range 3-63) years.36 Nineteen received their HCT from HLA-matched family members (18 siblings and one father), and five patients received their HCT from HLA-matched unrelated donors. The 5-year probability of progressionfree survival was 85% [95% confidence interval (CI) 70-100%], suggesting that results after a reduced-intensity conditioning regimen may be as good as after myeloab-lative conditioning in chronic-phase CML. Feinstein et al.61 reported outcomes in 18 patients with de novo (n = 13) or secondary (n = 5) AML in first complete remission who received a nonmyeloablative HCT from HLA-identical sibling donors. Median age was 59 (range 36-73) years. Conditioning consisted of 2 Gy TBI alone (n = 10) or combined with fludarabine (n = 8). Two rejections were observed in patients not given fludara-bine, and one of the two died with relapse. At a median follow-up of 766 days, seven patients have remained in complete remission. The 1-year estimates of TRM, overall survival, and progression-free survival were 17 (95% CI 0-35%), 54 (95% CI 31-78%), and 42% (95% CI 19-66%), respectively. For the 13 patients older than 55 years, the figures were 8 (95% CI 0-22%), 68 (95% CI 43-94%), and 59% (95% CI 31-87%), respectively. These results are promising, as the 1-year progressionfree survival for AML patients older than 55 years is around 45% with conventional chemotherapy.

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