Reduced Intensity Compared to Non-myeloablative Conditioning in Patients with Non-Hodgkin Lymphoma undergoing Allogeneic Hematopoietic Stem Cell Transplantation

氟达拉滨 全身照射 医学 环磷酰胺 布苏尔班 内科学 移植 梅尔法兰 外科 造血干细胞移植 胃肠病学 噻替帕 养生 肿瘤科 化疗
作者
Karthik Nath,Kristen Peterson,Samantha Brown,Sean M. Devlin,Natasia Rodriguez,Juliet N. Barker,Sergío Giralt,Boglarka Gyurkocza,Ann A. Jakubowski,Esperanza B. Papadopoulos,Doris M. Ponce,Michael Scordo,Gunjan L. Shah,Miguel Angel Perales,Craig S. Sauter,Andrew Lin,Parastoo B. Dahi
标识
DOI:10.1016/j.jtct.2023.09.022
摘要

. Reduced intensity (RIC) and non-myeloablative (NMA) conditioning are preferred for patients with non-Hodgkin lymphoma (NHL) receiving allogeneic hematopoietic stem cell transplantation (allo-HCT). Although prior studies have suggested that higher-intensity regimens within RIC-NMA conditioning are associated with inferior outcomes in patients with NHL, the optimal conditioning regimen remains unknown.. We performed a retrospective single-center analysis to determine outcomes of adult patients with B- and T-cell NHL who underwent allo-HCT and received either RIC or NMA conditioning between March 2008 - December 2019. RIC regimens included fludarabine-cyclophosphamide-thiotepa-4Gy-total body irradiation (Flu-Cy-TT-4Gy-TBI), fludarabine-melphalan (Flu-Mel), fludarabine-cyclophosphamide-4Gy-total body irradiation (Flu-Cy-4Gy-TBI) and fludarabine-busulfan-4 (Flu-Bu-4). The NMA regimen included fludarabine-cyclophosphamide-2Gy-total body irradiation (Flu-Cy-2Gy-TBI). The primary outcome was overall survival. Secondary outcomes included progression-free survival, non-relapse mortality and the incidence of acute and chronic graft-vs-host-disease (GvHD).. Of 279 transplanted patients (median age, 58 years), 110 received RIC (55% Flu-Mel, 38% Flu-Cy-TT-4Gy-TBI, 6% Flu-Bu-4, 1% Flu-Cy-4Gy-TBI) and 169 received NMA conditioning with Flu-Cy-2Gy-TBI. With a median of 64 months of follow-up from allo-HCT, there was no significant difference in overall survival between the NMA and RIC groups (median not reached [NR] vs 103 months, respectively. P = 0.1), and this was maintained on multivariable analysis. Similarly, after adjustment for all independently significant covariates (age, Karnofsky performance status, HCT-CI, disease histology), the regression analysis showed no significant difference in progression-free survival with RIC compared to NMA conditioning (hazard ratio [HR] 1.38; 95% CI 0.92 - 2.09, P = 0.24). On univariable analysis, there was no significant difference in non-relapse mortality between RIC and NMA conditioning (100-day estimates: 10.0% vs. 1.8%, respectively, P = 0.5). After adjustment for age, ethnicity, Karnofsky performance score, HCT-CI, GvHD prophylaxis and donor source, RIC conditioning was associated with a significantly higher incidence of non-relapse mortality compared to NMA conditioning (HR 2.61, 95% CI 1.04 - 6.52, P = 0.039). On multivariable analysis, compared with the Flu-Cy-2Gy-TBI regimen, the RIC cohort had higher rates of grade II-IV (HR, 2.25; 95% CI, 1.31 - 3.86; P = 0.002) and grade III-IV acute GvHD (HR, 5.62; 95% CI, 2.03 - 15.6; P < 0.001).. The findings of this study suggest that NMA conditioning with Flu-Cy-TBI-2Gy may be considered over more intensive RIC regimens for patients with NHL undergoing allo-HCT.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
1秒前
1秒前
mr.pork完成签到,获得积分20
3秒前
5秒前
ding应助饼饼采纳,获得10
5秒前
mr.pork发布了新的文献求助10
5秒前
小马甲应助鲤鱼似狮采纳,获得10
7秒前
7秒前
ttt完成签到,获得积分10
9秒前
饼饼完成签到,获得积分10
11秒前
科研通AI5应助王华楠采纳,获得10
12秒前
13秒前
14秒前
14秒前
gao应助cindywu采纳,获得10
16秒前
顾矜应助郭小宝采纳,获得10
17秒前
18秒前
19秒前
英子发布了新的文献求助10
19秒前
肝胆外科医生完成签到,获得积分10
19秒前
淡定草丛发布了新的文献求助10
20秒前
Ella完成签到,获得积分10
21秒前
21秒前
天天开心完成签到,获得积分10
22秒前
23秒前
23秒前
研友_ngkyGn应助徐rl采纳,获得10
24秒前
科研通AI2S应助张于小丸子采纳,获得10
24秒前
24秒前
Kris发布了新的文献求助10
25秒前
alex完成签到,获得积分10
27秒前
28秒前
郭小宝发布了新的文献求助10
28秒前
30秒前
泡面养鱼发布了新的文献求助10
31秒前
ding应助大头采纳,获得10
32秒前
臧佳莹发布了新的文献求助10
33秒前
量子星尘发布了新的文献求助10
33秒前
咚咚完成签到 ,获得积分10
34秒前
王华楠发布了新的文献求助10
35秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
‘Unruly’ Children: Historical Fieldnotes and Learning Morality in a Taiwan Village (New Departures in Anthropology) 400
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
基于可调谐半导体激光吸收光谱技术泄漏气体检测系统的研究 350
Robot-supported joining of reinforcement textiles with one-sided sewing heads 320
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3988997
求助须知:如何正确求助?哪些是违规求助? 3531351
关于积分的说明 11253520
捐赠科研通 3269928
什么是DOI,文献DOI怎么找? 1804830
邀请新用户注册赠送积分活动 882063
科研通“疑难数据库(出版商)”最低求助积分说明 809068