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Blood, 15 February 2007, Vol. 109, No. 4, pp. 1395-1400. Prepublished online as a Blood First Edition Paper on October 12, 2006; DOI 10.1182/blood-2006-05-021907. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2006-05-021907v1 109/4/1395    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Estey, E. Articles by Giralt, S. Search for Related Content PubMed PubMed Citation Articles by Estey, E. Articles by Giralt, S. Related Collections Neoplasia Transplantation Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Prospective feasibility analysis of reduced-intensity conditioning (RIC) regimens for hematopoietic stem cell transplantation (HSCT) in elderly patients with acute myeloid leukemia (AML) and high-risk myelodysplastic syndrome (MDS) Elihu Estey1, Marcos de Lima2, Raoul Tibes1, Sherry Pierce1, Hagop Kantarjian1, Richard Champlin2, and Sergio Giralt2 Departments of1 Leukemia and 2 Blood and Marrow Transplantation, The University of Texas M. D. Anderson Cancer Center, Houston, TX To prospectively assess the applicability of reduced-intensity conditioning hematopoietic stem cell transplantation (RIC-HSCT), we wrote a protocol in which all untreated patients 50 years or older with acute myeloid leukemia (AML) and unfavorable cytogenetics would be evaluated during induction for a possible RIC-HSCT in first complete remission (CR1). Ninety-nine of 259 patients entered CR. Fifty-three of the 99 were seen by the Transplant Service with the remainder not seen because of illness, lack/unavailability of siblings, refusal, or, primarily, unclear reasons (21 patients). A donor was identified for 26 patients (21 sibling, 5 unrelated) with RIC-HSCT performed in 14 (13 sibling). Results in consulted patients suggested that 50% or fewer of the 85 patients who did not undergo transplantation were potential transplant candidates. We attempted to find one or more chemotherapy pair-mates for each patient who underwent transplantation based on cytogenetics, age, and a relapse-free survival (RFS) time that was more than or equal to the time from CR1 to RIC-HSCT in the patient who underwent transplantation. Thirty-two of the 39 matches favored (longer RFS) RIC-HSCT and 7, chemotherapy. The probability that the corresponding beta distribution was different than expected (ie, that RIC-HSCT was superior) was 0.99 (P = .004). Results were similar with respect to survival. While RIC-HSCT thus seems of interest, methods are needed to extend its applicability. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: H. D. Klepin and L. Balducci Acute Myelogenous Leukemia in Older Adults Oncologist, March 1, 2009; 14(3): 222 - 232. [Abstract] [Full Text] [PDF] E. H. Estey Treatment of acute myeloid leukemia Haematologica, January 1, 2009; 94(1): 10 - 16. [Full Text] [PDF] G. J. Roboz Treatment of Elderly Patients with Acute Myeloid Leukemia: Lowering the Intensity ASCO Educational Book, January 1, 2009; 2009(1): 378 - 383. [Abstract] [Full Text] [PDF] J. Schetelig, M. Bornhauser, C. Schmid, B. Hertenstein, R. Schwerdtfeger, H. Martin, M. Stelljes, U. Hegenbart, K. Schafer-Eckart, M. Fussel, et al. Matched Unrelated or Matched Sibling Donors Result in Comparable Survival After Allogeneic Stem-Cell Transplantation in Elderly Patients With Acute Myeloid Leukemia: A Report From the Cooperative German Transplant Study Group J. Clin. Oncol., November 10, 2008; 26(32): 5183 - 5191. [Abstract] [Full Text] [PDF] M. R. Baer, H. D. Klepin, and A. S. Artz Acute Leukemia in Older Adults: Are We Treating Too Much or Too Little? ASCO Educational Book, January 1, 2008; 2008(1): 216 - 223. [Abstract] [Full Text] [PDF] E. Estey Acute Myeloid Leukemia and Myelodysplastic Syndromes in Older Patients J. Clin. Oncol., May 10, 2007; 25(14): 1908 - 1915. [Abstract] [Full Text] [PDF] J. H. Antin Reduced-Intensity Stem Cell Transplantation: "...whereof a little More than a little is by much too much." King Henry IV, part 1, I, 2 Hematology, January 1, 2007; 2007(1): 47 - 54. [Abstract] [Full Text] [PDF] H. P. Erba Prognostic Factors in Elderly Patients with AML and the Implications for Treatment Hematology, January 1, 2007; 2007(1): 420 - 428. [Abstract] [Full Text] [PDF]

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