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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Influence of comorbidities on transplant outcomes in patients aged 50 years or more after myeloablative conditioning incorporating fludarabine, BU and ATG
Bone Marrow Transplantation, Volume 46, No. 8, Year 2011
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Description
Non-myeloablative (MA) and reduced intensity allo-SCT regimens are offered to older patients and/or those with comorbidities because the morbidity and mortality attributable to fully MA conditioning is thought to be unacceptably high. A total of 207 patients aged 50-66 years were treated between 1999 and 2008 with SCT after MA conditioning with fludarabine 50 mg/m 2 daily × 5 and i.v. BU 3.2 mg/kg daily × 4.90 (43%) had additional TBI 200 cGy × 2. GVHD prophylaxis was CsA, MTX and thymoglobulin (4.5 mg/kg total dose). As defined by the hematopoietic cell transplantation co-morbidity index (HCT-CI) scoring system 117 (57%) pts scored 0 and 90 (43%) ≥1. At 5 years OS was 39 vs 54% (P=0.008), disease-free survival 38 vs 49% (P=0.03), TRM 39 vs 19% (P=0.003) and relapse 36 vs 39% (Pns) in those with scores of 0 and 1, respectively. Multivariate analysis confirmed the influence of HCT-CI scores on TRM (subhazard ratios=2.29; 95% confidence interval=1.29-4.08; P=0.005). We conclude that comorbidities as assessed by the HCT-CI do influence TRM with this regimen but that age alone should not be an indication to prefer a less intense protocol. © 2011 Macmillan Publishers Limited. All rights reserved.
Authors & Co-Authors
El-Kourashy, Shaza Abd Elwahab Ahmed
Canada, Calgary
Foothills Medical Centre
Egypt, Cairo
Faculty of Medicine - Ain Shams University
Williamson, Tyler
Canada, Calgary
University of Calgary
Chaudhry, M. A.
Canada, Calgary
Foothills Medical Centre
Savoie, Mary Lynn
Canada, Calgary
Foothills Medical Centre
Turner, A. Robert
Canada, Edmonton
Cross Cancer Institute
Larratt, Loree M.
Canada, Edmonton
Cross Cancer Institute
Storek, Jan
Canada, Calgary
Foothills Medical Centre
Bahlis, N. J.
Canada, Calgary
Foothills Medical Centre
Brown, C. B.
Canada, Calgary
Foothills Medical Centre
Yang, M.
Canada, Calgary
Foothills Medical Centre
Quinlan, D.
Canada, Calgary
Foothills Medical Centre
Geddes, M.
Canada, Calgary
Foothills Medical Centre
Zacarias, N.
Canada, Calgary
Foothills Medical Centre
Daly, Andrew
Canada, Calgary
Foothills Medical Centre
Duggan, P.
Canada, Calgary
Foothills Medical Centre
Stewart, D. A.
Canada, Calgary
Foothills Medical Centre
Russell, James A.
Canada, Calgary
Foothills Medical Centre
Statistics
Citations: 17
Authors: 17
Affiliations: 4
Identifiers
Doi:
10.1038/bmt.2010.257
ISSN:
02683369
e-ISSN:
14765365