• R Rodriguez, P Parker, A Nademanee, D Smith, M R O'Donnell, A Stein, D S Snyder, H C Fung, A Y Krishnan, L Popplewell, S Cohen, G Somlo, M Angelopoulou, Z Al-Kadhimi, P M Falk, R Spielberger, N Kogut, F Sahebi, D Senitzer, M Slovak, J Schriber, and S J Forman.
• City of Hope National Medical Center, Duarte, CA 91010, USA. robertorodriguez@coh.org
• Bone Marrow Transplant. 2004 Jun 1; 33 (11): 1123-9.

AbstractIn an attempt to decrease toxicity in high-risk patients undergoing unrelated donor hematopoietic stem cell transplantation (URD HSCT), we tested a combination of cyclosporine (CSP) and mycophenolate mofetil (MMF) as graft-versus-host disease (GVHD) prophylaxis with the reduced-intensity conditioning regimen fludarabine/melphalan (Flu/Mel). A total of 22 adult patients with advanced myeloid (n=15) and lymphoid (n=7) malignancies were treated. All patients received Flu 25 mg/m2 for 5 days and Mel 140 mg/m2, with CSP 3 mg/kg daily and MMF 15 mg/kg three times a day. The median age was 49 years (range 18-66). Durable engraftment was seen in all but one patient with myelofibrosis. The 1-year nonrelapse mortality was 32%, 27% from GVHD. The cumulative incidence of acute GVHD grade 2-4 and 3-4 was 63 and 41%, respectively. With a median follow-up of 18 months, the disease-free survival (DFS) and overall survival (OS) are 55 and 59%, respectively. For patients with AML and MDS (n=14), the DFS and OS is 71%. For patients undergoing a second transplant (n=14), the DFS and OS is 57%. In conclusion, this regimen is associated with acceptable toxicity but high rates of GVHD in high-risk patients undergoing URD HSCT. Encouraging disease control for patients with advanced myeloid malignancies was observed.Copyright 2004 Nature Publishing Group

37 keywords...

hide…