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dc.contributor.authorCraddock, Charles
dc.contributor.authorNagra, Sandeep
dc.contributor.authorPeniket, Andrew
dc.contributor.authorBrookes, Cassandra
dc.contributor.authorBuckley, Laura
dc.contributor.authorNikolousis, Emmanouil
dc.contributor.authorDuncan, Nick
dc.contributor.authorTauro, Sudhir
dc.contributor.authorYin, John A
dc.contributor.authorLiakopoulou, Effie F
dc.contributor.authorKottaridis, Panagiotis D
dc.contributor.authorSnowden, John
dc.contributor.authorMilligan, Donald W
dc.contributor.authorCook, Gordon
dc.contributor.authorTholouli, Eleni
dc.contributor.authorLittlewood, Timothy
dc.contributor.authorPeggs, Karl S
dc.contributor.authorVyas, Paresh
dc.contributor.authorClark, Fiona
dc.contributor.authorCook, Mark
dc.contributor.authorMackinnon, Stephen
dc.contributor.authorRussell, Nigel
dc.date.accessioned2010-09-14T10:31:46Zen
dc.date.available2010-09-14T10:31:46Zen
dc.date.issued2010-06en
dc.identifier.citationFactors predicting long-term survival after T-cell depleted reduced intensity allogeneic stem cell transplantation for acute myeloid leukemia. 2010, 95 (6):989-95 Haematologicaen
dc.identifier.issn1592-8721en
dc.identifier.pmid19951968en
dc.identifier.doi10.3324/haematol.2009.013920en
dc.identifier.urihttp://hdl.handle.net/10541/111117en
dc.description.abstractBACKGROUND: Reduced intensity conditioning regimens permit the delivery of a potentially curative graft-versus-leukemia effect in older patients with acute myeloid leukemia. Although T-cell depletion is increasingly used to reduce the risk of graft-versus-host disease its impact on the graft-versus-leukemia effect and long-term outcome post-transplant is unknown. DESIGN AND METHODS: We have characterized pre- and post-transplant factors determining overall survival in 168 patients with acute myeloid leukemia transplanted using an alemtuzumab based reduced intensity conditioning regimen with a median duration of follow-up of 37 months. RESULTS: The 3-year overall survival for patients transplanted in CR1 or CR2/CR3 was 50% (95% CI, 38% to 62%) and 44% (95% CI, 31% to 56%), respectively compared to 15% (95% CI, 2% to 36%) for patients with relapsed/refractory disease. Multivariate analysis demonstrated that both survival and disease relapse were influenced by status at transplant (P=0.008) and presentation cytogenetics (P=0.01). Increased exposure to cyclosporine A (CsA) in the first 21 days post-transplant was associated with an increased relapse risk (P<0.0001) and decreased overall survival (P<0.0001). CONCLUSIONS: Disease stage, presentation karyotype and post-transplant CsA exposure are important predictors of outcome in patients undergoing a T-cell depleted reduced intensity conditioning allograft for acute myeloid leukemia. These data confirm the presence of a potent graft-versus-leukemia effect after a T-cell depleted reduced intensity conditioning allograft in acute myeloid leukemia and identify CsA exposure as a manipulable determinant of outcome in this setting.
dc.language.isoenen
dc.subjectAcute Myeloid Leukaemiaen
dc.subjectStem Cell Transplantationen
dc.titleFactors predicting long-term survival after T-cell depleted reduced intensity allogeneic stem cell transplantation for acute myeloid leukemia.en
dc.typeArticleen
dc.contributor.departmentCentre for Clinical Haematology, Main Drive, Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2TH, UK. charles.craddock@uhb.nhs.uken
dc.identifier.journalHaematologicaen
html.description.abstractBACKGROUND: Reduced intensity conditioning regimens permit the delivery of a potentially curative graft-versus-leukemia effect in older patients with acute myeloid leukemia. Although T-cell depletion is increasingly used to reduce the risk of graft-versus-host disease its impact on the graft-versus-leukemia effect and long-term outcome post-transplant is unknown. DESIGN AND METHODS: We have characterized pre- and post-transplant factors determining overall survival in 168 patients with acute myeloid leukemia transplanted using an alemtuzumab based reduced intensity conditioning regimen with a median duration of follow-up of 37 months. RESULTS: The 3-year overall survival for patients transplanted in CR1 or CR2/CR3 was 50% (95% CI, 38% to 62%) and 44% (95% CI, 31% to 56%), respectively compared to 15% (95% CI, 2% to 36%) for patients with relapsed/refractory disease. Multivariate analysis demonstrated that both survival and disease relapse were influenced by status at transplant (P=0.008) and presentation cytogenetics (P=0.01). Increased exposure to cyclosporine A (CsA) in the first 21 days post-transplant was associated with an increased relapse risk (P<0.0001) and decreased overall survival (P<0.0001). CONCLUSIONS: Disease stage, presentation karyotype and post-transplant CsA exposure are important predictors of outcome in patients undergoing a T-cell depleted reduced intensity conditioning allograft for acute myeloid leukemia. These data confirm the presence of a potent graft-versus-leukemia effect after a T-cell depleted reduced intensity conditioning allograft in acute myeloid leukemia and identify CsA exposure as a manipulable determinant of outcome in this setting.


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