Long-term survival with low toxicity after allogeneic transplantation for acute myeloid leukaemia and myelodysplasia using non-myeloablative conditioning without T cell depletion

Br J Haematol. 2013 Aug;162(4):525-9. doi: 10.1111/bjh.12402. Epub 2013 May 29.

Abstract

The toxicity burden and long-term anti-leukaemic effect of non-myeloablative (NMA) allogeneic haematopoietic stem-cell transplantation (AHSCT) for acute myeloid leukaemia (AML) and myelodysplasia (MDS) remains undefined. We report the outcome of 56 patients with AML/MDS transplanted from human leucocyte antigen-matched donors using NMA conditioning without T-cell depletion. With a median follow-up of 5 years, treatment-related mortality was 9% and current disease-free survival (CDFS) was 45% (overall) and 55% (patients transplanted in remission). Development of graft-versus-host disease upon withdrawal of post-transplant immunosuppression was associated with less relapse and better CDFS. These data confirm that NMA AHSCT without T-cell depletion is safe and can result in sustained remissions of AML/MDS.

Keywords: Transplantation; acute myeloid leukaemia; myelodysplasia; reduced intensity conditioning.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cytomegalovirus Infections / epidemiology
  • Disease-Free Survival
  • Female
  • Graft Survival
  • Graft vs Host Disease / epidemiology
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Immunosuppression Therapy
  • Kaplan-Meier Estimate
  • Length of Stay
  • Leukemia, Myeloid, Acute / drug therapy
  • Leukemia, Myeloid, Acute / mortality
  • Leukemia, Myeloid, Acute / surgery*
  • Lymphocyte Depletion*
  • Lymphoproliferative Disorders / epidemiology
  • Male
  • Middle Aged
  • Myelodysplastic Syndromes / drug therapy
  • Myelodysplastic Syndromes / mortality
  • Myelodysplastic Syndromes / surgery*
  • Postoperative Complications / epidemiology
  • Sepsis / epidemiology
  • T-Lymphocytes*
  • Transplantation Conditioning / methods*
  • Transplantation Conditioning / mortality
  • Transplantation, Homologous
  • Young Adult