Abstract
We report a consecutive series of 59 patients with MDS who underwent reduced-intensity hematopoietic stem cell transplantation (RI-HSCT) with fludarabine/melphalan conditioning and tacrolimus/sirolimus-based GVHD prophylaxis. Two-year OS, EFS, and relapse incidences were 75.1%, 65.2%, and 20.9%, respectively. The cumulative incidence of non-relapse mortality at 100 days, 1 year, and 2 years was 3.4%, 8.5%, and 10.5%, respectively. The incidence of grade II-IV acute GVHD was 35.4%; grade III-IV was 18.6%. Forty of 55 evaluable patients developed chronic GVHD; of these 35 were extensive grade. This RI-HSCT protocol produces encouraging outcomes in MDS patients, and tacrolimus/sirolimus-based GVHD prophylaxis may contribute to that promising result.
Copyright © 2012 Elsevier Ltd. All rights reserved.
Publication types
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Evaluation Study
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Research Support, N.I.H., Extramural
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Research Support, Non-U.S. Gov't
MeSH terms
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Adult
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Aged
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Chemoprevention / methods
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Dose-Response Relationship, Drug
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Drug Combinations
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Female
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Graft vs Host Disease / epidemiology
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Graft vs Host Disease / etiology
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Graft vs Host Disease / mortality
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Graft vs Host Disease / prevention & control*
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Hematopoietic Stem Cell Transplantation* / adverse effects
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Hematopoietic Stem Cell Transplantation* / methods
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Humans
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Immunosuppressive Agents / administration & dosage
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Incidence
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Male
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Melphalan / administration & dosage
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Melphalan / adverse effects
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Middle Aged
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Myelodysplastic Syndromes / diagnosis
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Myelodysplastic Syndromes / drug therapy
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Myelodysplastic Syndromes / mortality
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Myelodysplastic Syndromes / therapy*
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Retrospective Studies
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Sirolimus / administration & dosage*
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Survival Analysis
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Tacrolimus / administration & dosage*
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Transplantation Conditioning / methods*
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Transplantation, Homologous
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Vidarabine / administration & dosage
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Vidarabine / analogs & derivatives
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Young Adult
Substances
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Drug Combinations
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Immunosuppressive Agents
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Vidarabine
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fludarabine
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Melphalan
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Sirolimus
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Tacrolimus