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10-Year Data on Allo-HCT: Reduced-Intensity Versus Standard Conditioning Regimens

By: Celeste L. Dixon
Posted: Tuesday, June 2, 2020

Retrospective, long-term follow-up data appear to support the long-term efficacy of reduced-intensity conditioning allogeneic hematopoietic cell transplantation (HCT) for older patients with acute myeloid leukemia (AML), according to an article in Bone Marrow Transplantation. According to study authors Masamitsu Yanada, MD, PhD, of Aichi Cancer Center, Nagoya, Japan, and colleagues, their findings should “mitigate concerns over an increase in late relapse” with reduced-intensity versus myeloablative conditioning.

The Japan-wide registry-based study included patients with AML who were 50 years or older and who had undergone allogeneic HCT in complete remission. Reduced-intensity conditioning was received by 284 patients with AML, and myeloablative conditioning was received by 190 patients with AML between 2002 and 2007.

Based on a multivariate analysis, conditioning intensity did not affect overall mortality (P = .184), relapse (P = .904), or nonrelapse mortality (P = .387). “The 10-year probabilities of overall survival, relapse, and nonrelapse mortality were 36.4%, 30.0%, and 35.7% for reduced-intensity conditioning recipients and 39.8%, 26.3%, and 35.5% for myeloablative conditioning recipients, respectively,” they noted. The median follow-up period for surviving patients was 10.1 years with reduced-intensity conditioning and 10.4 years with myeloablative conditioning.

Among the propensity score–matched pairs of patients (109 pairs, 218 patients), nonrelapse

mortality was significantly lower for the recipients of reduced-intensity conditioning (P = .046). This translated into a tendency for better overall survival, noted Dr. Yanada and co-investigators. “On the other hand, consistent with the findings of our standard multivariate analysis, the matched-pair analysis shows no difference in relapse between reduced-intensity conditioning and myeloablative conditioning (P = .467), thus providing further support for the absence of disadvantage with reduced-intensity conditioning,” they concluded.

Disclosure: The study authors reported no conflicts of interest.


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