Relapse risk in patients with malignant diseases given allogeneic hematopoietic cell transplantation after nonmyeloablative conditioning
Allogeneic hematopoietic cell transplantation (HCT) after nonmyeloablative conditioning for hematologic malignancies depends on graft-versus-tumor effects for eradication of cancer. Here, we estimated relapse risks according to disease characteristics. Between 1997 and 2006, 834 consecutive patients...
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| Veröffentlicht in: | Blood 2007-10, Vol.110 (7), p.2744-2748 |
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| creator | Kahl, Christoph Storer, Barry E. Sandmaier, Brenda M. Mielcarek, Marco Maris, Michael B. Blume, Karl G. Niederwieser, Dietger Chauncey, Thomas R. Forman, Stephen J. Agura, Edward Leis, Jose F. Bruno, Benedetto Langston, Amelia Pulsipher, Michael A. McSweeney, Peter A. Wade, James C. Epner, Elliot Bo Petersen, Finn Bethge, Wolfgang A. Maloney, David G. Storb, Rainer |
| description | Allogeneic hematopoietic cell transplantation (HCT) after nonmyeloablative conditioning for hematologic malignancies depends on graft-versus-tumor effects for eradication of cancer. Here, we estimated relapse risks according to disease characteristics. Between 1997 and 2006, 834 consecutive patients (median age, 55 years; range, 5-74 years) received related (n = 498) or unrelated (n = 336) HCT after 2 Gy total body irradiation alone (n = 171) or combined with fludarabine (90 mg/m2; n = 663). Relapse rates per patient year (PY) at risk, corrected for follow-up and competing nonrelapse mortality, were calculated for 29 different diseases and stages. The overall relapse rate per PY was 0.36. Patients with chronic lymphocytic leukemia (CLL) and multiple myeloma (MM) in remission (CR), low-grade or mantle cell non-Hodgkin lymphoma (NHL) (CR + partial remission [PR]), and high-grade NHL-CR had the lowest rates (0.00-0.24; low risk). In contrast, patients with advanced myeloid and lymphoid malignancies had rates of more than 0.52 (high risk). Patients with lymphoproliferative diseases not in CR (except Hodgkin lymphoma and high-grade NHL) and myeloid malignancies in CR had rates of 0.26-0.37 (standard risk). In conclusion, patients with low-grade lymphoproliferative disorders experienced the lowest relapse rates, whereas patients with advanced myeloid and lymphoid malignancies had high relapse rates after nonmyeloablative HCT. The latter might benefit from cytoreductive treatment before HCT. |
| doi_str_mv | 10.1182/blood-2007-03-078592 |
| format | Article |
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Here, we estimated relapse risks according to disease characteristics. Between 1997 and 2006, 834 consecutive patients (median age, 55 years; range, 5-74 years) received related (n = 498) or unrelated (n = 336) HCT after 2 Gy total body irradiation alone (n = 171) or combined with fludarabine (90 mg/m2; n = 663). Relapse rates per patient year (PY) at risk, corrected for follow-up and competing nonrelapse mortality, were calculated for 29 different diseases and stages. The overall relapse rate per PY was 0.36. Patients with chronic lymphocytic leukemia (CLL) and multiple myeloma (MM) in remission (CR), low-grade or mantle cell non-Hodgkin lymphoma (NHL) (CR + partial remission [PR]), and high-grade NHL-CR had the lowest rates (0.00-0.24; low risk). In contrast, patients with advanced myeloid and lymphoid malignancies had rates of more than 0.52 (high risk). Patients with lymphoproliferative diseases not in CR (except Hodgkin lymphoma and high-grade NHL) and myeloid malignancies in CR had rates of 0.26-0.37 (standard risk). In conclusion, patients with low-grade lymphoproliferative disorders experienced the lowest relapse rates, whereas patients with advanced myeloid and lymphoid malignancies had high relapse rates after nonmyeloablative HCT. The latter might benefit from cytoreductive treatment before HCT.</description><identifier>ISSN: 0006-4971</identifier><identifier>EISSN: 1528-0020</identifier><identifier>DOI: 10.1182/blood-2007-03-078592</identifier><identifier>PMID: 17595333</identifier><language>eng</language><publisher>Washington, DC: Elsevier Inc</publisher><subject>Adolescent ; Adult ; Aged ; Biological and medical sciences ; Cell Separation ; Child ; Child, Preschool ; Female ; Granulocyte Precursor Cells - pathology ; Hematologic and hematopoietic diseases ; Hematopoietic Stem Cell Transplantation ; Humans ; Leukemia - classification ; Leukemia - epidemiology ; Leukemia - pathology ; Leukemia - surgery ; Male ; Medical sciences ; Middle Aged ; Recurrence ; Risk ; Survival Rate ; Transplantation ; Transplantation Conditioning - methods ; Transplantation, Homologous</subject><ispartof>Blood, 2007-10, Vol.110 (7), p.2744-2748</ispartof><rights>2007 American Society of Hematology</rights><rights>2008 INIST-CNRS</rights><rights>2007 by The American Society of Hematology 2007</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c491t-ec74689f7f438be8d329471becefadb9ded24765c413e4deb5fdc399405d36ae3</citedby><cites>FETCH-LOGICAL-c491t-ec74689f7f438be8d329471becefadb9ded24765c413e4deb5fdc399405d36ae3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=19127650$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17595333$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kahl, Christoph</creatorcontrib><creatorcontrib>Storer, Barry E.</creatorcontrib><creatorcontrib>Sandmaier, Brenda M.</creatorcontrib><creatorcontrib>Mielcarek, Marco</creatorcontrib><creatorcontrib>Maris, Michael B.</creatorcontrib><creatorcontrib>Blume, Karl G.</creatorcontrib><creatorcontrib>Niederwieser, Dietger</creatorcontrib><creatorcontrib>Chauncey, Thomas R.</creatorcontrib><creatorcontrib>Forman, Stephen J.</creatorcontrib><creatorcontrib>Agura, Edward</creatorcontrib><creatorcontrib>Leis, Jose F.</creatorcontrib><creatorcontrib>Bruno, Benedetto</creatorcontrib><creatorcontrib>Langston, Amelia</creatorcontrib><creatorcontrib>Pulsipher, Michael A.</creatorcontrib><creatorcontrib>McSweeney, Peter A.</creatorcontrib><creatorcontrib>Wade, James C.</creatorcontrib><creatorcontrib>Epner, Elliot</creatorcontrib><creatorcontrib>Bo Petersen, Finn</creatorcontrib><creatorcontrib>Bethge, Wolfgang A.</creatorcontrib><creatorcontrib>Maloney, David G.</creatorcontrib><creatorcontrib>Storb, Rainer</creatorcontrib><title>Relapse risk in patients with malignant diseases given allogeneic hematopoietic cell transplantation after nonmyeloablative conditioning</title><title>Blood</title><addtitle>Blood</addtitle><description>Allogeneic hematopoietic cell transplantation (HCT) after nonmyeloablative conditioning for hematologic malignancies depends on graft-versus-tumor effects for eradication of cancer. Here, we estimated relapse risks according to disease characteristics. Between 1997 and 2006, 834 consecutive patients (median age, 55 years; range, 5-74 years) received related (n = 498) or unrelated (n = 336) HCT after 2 Gy total body irradiation alone (n = 171) or combined with fludarabine (90 mg/m2; n = 663). Relapse rates per patient year (PY) at risk, corrected for follow-up and competing nonrelapse mortality, were calculated for 29 different diseases and stages. The overall relapse rate per PY was 0.36. Patients with chronic lymphocytic leukemia (CLL) and multiple myeloma (MM) in remission (CR), low-grade or mantle cell non-Hodgkin lymphoma (NHL) (CR + partial remission [PR]), and high-grade NHL-CR had the lowest rates (0.00-0.24; low risk). In contrast, patients with advanced myeloid and lymphoid malignancies had rates of more than 0.52 (high risk). Patients with lymphoproliferative diseases not in CR (except Hodgkin lymphoma and high-grade NHL) and myeloid malignancies in CR had rates of 0.26-0.37 (standard risk). In conclusion, patients with low-grade lymphoproliferative disorders experienced the lowest relapse rates, whereas patients with advanced myeloid and lymphoid malignancies had high relapse rates after nonmyeloablative HCT. The latter might benefit from cytoreductive treatment before HCT.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Cell Separation</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Female</subject><subject>Granulocyte Precursor Cells - pathology</subject><subject>Hematologic and hematopoietic diseases</subject><subject>Hematopoietic Stem Cell Transplantation</subject><subject>Humans</subject><subject>Leukemia - classification</subject><subject>Leukemia - epidemiology</subject><subject>Leukemia - pathology</subject><subject>Leukemia - surgery</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Recurrence</subject><subject>Risk</subject><subject>Survival Rate</subject><subject>Transplantation</subject><subject>Transplantation Conditioning - methods</subject><subject>Transplantation, Homologous</subject><issn>0006-4971</issn><issn>1528-0020</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc2KFDEUhYMoTjv6BiLZ6K40f_WTjSDD6AwMCKLrkEpuVUdTSZmkW-YNfGzTdmPrxlVI8t1z77kHoeeUvKZ0YG9GH6NtGCF9Q3hD-qGV7AHa0JYNDSGMPEQbQkjXCNnTC_Qk56-EUMFZ-xhd0L6VLed8g35-Aq_XDDi5_A27gFddHISS8Q9XtnjR3s1Bh4Kty6AzZDy7PQSsvY8zBHAGb2HRJa7RQak3A97jknTIq691VS1WeiqQcIhhuQcf9ejr8x6wicG6A-DC_BQ9mrTP8Ox0XqIv768_X900dx8_3F69u2uMkLQ0YHrRDXLqJ8GHEQbLmRQ9HcHApO0oLVgm-q41gnIQFsZ2soZLKUhreaeBX6K3R911Ny5gTfWatFdrcotO9ypqp_79CW6r5rhXVA6DbGkVeHUSSPH7DnJRi8sH1zpA3GXVDUzSnvEKiiNoUsw5wfSnCSXqEKH6HaE6RKgIV8cIa9mLvwc8F50yq8DLE6Cz0X6quzYunzlJWV0AOTuFus69g6SyqdEasC6BKcpG9_9JfgEIzsFX</recordid><startdate>20071001</startdate><enddate>20071001</enddate><creator>Kahl, Christoph</creator><creator>Storer, Barry E.</creator><creator>Sandmaier, Brenda M.</creator><creator>Mielcarek, Marco</creator><creator>Maris, Michael B.</creator><creator>Blume, Karl G.</creator><creator>Niederwieser, Dietger</creator><creator>Chauncey, Thomas R.</creator><creator>Forman, Stephen J.</creator><creator>Agura, Edward</creator><creator>Leis, Jose F.</creator><creator>Bruno, Benedetto</creator><creator>Langston, Amelia</creator><creator>Pulsipher, Michael A.</creator><creator>McSweeney, Peter A.</creator><creator>Wade, James C.</creator><creator>Epner, Elliot</creator><creator>Bo Petersen, Finn</creator><creator>Bethge, Wolfgang A.</creator><creator>Maloney, David G.</creator><creator>Storb, Rainer</creator><general>Elsevier Inc</general><general>The Americain Society of Hematology</general><general>American Society of Hematology</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20071001</creationdate><title>Relapse risk in patients with malignant diseases given allogeneic hematopoietic cell transplantation after nonmyeloablative conditioning</title><author>Kahl, Christoph ; Storer, Barry E. ; Sandmaier, Brenda M. ; Mielcarek, Marco ; Maris, Michael B. ; Blume, Karl G. ; Niederwieser, Dietger ; Chauncey, Thomas R. ; Forman, Stephen J. ; Agura, Edward ; Leis, Jose F. ; Bruno, Benedetto ; Langston, Amelia ; Pulsipher, Michael A. ; McSweeney, Peter A. ; Wade, James C. ; Epner, Elliot ; Bo Petersen, Finn ; Bethge, Wolfgang A. ; Maloney, David G. ; Storb, Rainer</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c491t-ec74689f7f438be8d329471becefadb9ded24765c413e4deb5fdc399405d36ae3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Cell Separation</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Female</topic><topic>Granulocyte Precursor Cells - pathology</topic><topic>Hematologic and hematopoietic diseases</topic><topic>Hematopoietic Stem Cell Transplantation</topic><topic>Humans</topic><topic>Leukemia - classification</topic><topic>Leukemia - epidemiology</topic><topic>Leukemia - pathology</topic><topic>Leukemia - surgery</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Recurrence</topic><topic>Risk</topic><topic>Survival Rate</topic><topic>Transplantation</topic><topic>Transplantation Conditioning - methods</topic><topic>Transplantation, Homologous</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kahl, Christoph</creatorcontrib><creatorcontrib>Storer, Barry E.</creatorcontrib><creatorcontrib>Sandmaier, Brenda M.</creatorcontrib><creatorcontrib>Mielcarek, Marco</creatorcontrib><creatorcontrib>Maris, Michael B.</creatorcontrib><creatorcontrib>Blume, Karl G.</creatorcontrib><creatorcontrib>Niederwieser, Dietger</creatorcontrib><creatorcontrib>Chauncey, Thomas R.</creatorcontrib><creatorcontrib>Forman, Stephen J.</creatorcontrib><creatorcontrib>Agura, Edward</creatorcontrib><creatorcontrib>Leis, Jose F.</creatorcontrib><creatorcontrib>Bruno, Benedetto</creatorcontrib><creatorcontrib>Langston, Amelia</creatorcontrib><creatorcontrib>Pulsipher, Michael A.</creatorcontrib><creatorcontrib>McSweeney, Peter A.</creatorcontrib><creatorcontrib>Wade, James C.</creatorcontrib><creatorcontrib>Epner, Elliot</creatorcontrib><creatorcontrib>Bo Petersen, Finn</creatorcontrib><creatorcontrib>Bethge, Wolfgang A.</creatorcontrib><creatorcontrib>Maloney, David G.</creatorcontrib><creatorcontrib>Storb, Rainer</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Blood</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kahl, Christoph</au><au>Storer, Barry E.</au><au>Sandmaier, Brenda M.</au><au>Mielcarek, Marco</au><au>Maris, Michael B.</au><au>Blume, Karl G.</au><au>Niederwieser, Dietger</au><au>Chauncey, Thomas R.</au><au>Forman, Stephen J.</au><au>Agura, Edward</au><au>Leis, Jose F.</au><au>Bruno, Benedetto</au><au>Langston, Amelia</au><au>Pulsipher, Michael A.</au><au>McSweeney, Peter A.</au><au>Wade, James C.</au><au>Epner, Elliot</au><au>Bo Petersen, Finn</au><au>Bethge, Wolfgang A.</au><au>Maloney, David G.</au><au>Storb, Rainer</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Relapse risk in patients with malignant diseases given allogeneic hematopoietic cell transplantation after nonmyeloablative conditioning</atitle><jtitle>Blood</jtitle><addtitle>Blood</addtitle><date>2007-10-01</date><risdate>2007</risdate><volume>110</volume><issue>7</issue><spage>2744</spage><epage>2748</epage><pages>2744-2748</pages><issn>0006-4971</issn><eissn>1528-0020</eissn><abstract>Allogeneic hematopoietic cell transplantation (HCT) after nonmyeloablative conditioning for hematologic malignancies depends on graft-versus-tumor effects for eradication of cancer. Here, we estimated relapse risks according to disease characteristics. Between 1997 and 2006, 834 consecutive patients (median age, 55 years; range, 5-74 years) received related (n = 498) or unrelated (n = 336) HCT after 2 Gy total body irradiation alone (n = 171) or combined with fludarabine (90 mg/m2; n = 663). Relapse rates per patient year (PY) at risk, corrected for follow-up and competing nonrelapse mortality, were calculated for 29 different diseases and stages. The overall relapse rate per PY was 0.36. Patients with chronic lymphocytic leukemia (CLL) and multiple myeloma (MM) in remission (CR), low-grade or mantle cell non-Hodgkin lymphoma (NHL) (CR + partial remission [PR]), and high-grade NHL-CR had the lowest rates (0.00-0.24; low risk). In contrast, patients with advanced myeloid and lymphoid malignancies had rates of more than 0.52 (high risk). Patients with lymphoproliferative diseases not in CR (except Hodgkin lymphoma and high-grade NHL) and myeloid malignancies in CR had rates of 0.26-0.37 (standard risk). In conclusion, patients with low-grade lymphoproliferative disorders experienced the lowest relapse rates, whereas patients with advanced myeloid and lymphoid malignancies had high relapse rates after nonmyeloablative HCT. The latter might benefit from cytoreductive treatment before HCT.</abstract><cop>Washington, DC</cop><pub>Elsevier Inc</pub><pmid>17595333</pmid><doi>10.1182/blood-2007-03-078592</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Aged Biological and medical sciences Cell Separation Child Child, Preschool Female Granulocyte Precursor Cells - pathology Hematologic and hematopoietic diseases Hematopoietic Stem Cell Transplantation Humans Leukemia - classification Leukemia - epidemiology Leukemia - pathology Leukemia - surgery Male Medical sciences Middle Aged Recurrence Risk Survival Rate Transplantation Transplantation Conditioning - methods Transplantation, Homologous |
| title | Relapse risk in patients with malignant diseases given allogeneic hematopoietic cell transplantation after nonmyeloablative conditioning |
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