GLORIA

GEOMAR Library Ocean Research Information Access

X

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
  • 1
    Online Resource
    Online Resource
    Allogeneic Hematopoietic Stem Cell Transplantation Offers Similar Outcome after Myeloablative and Sequential Conditioning Regimen in Patients with Primary Refractory or Relapsed Acute Myeloid Leukemia: A Study from the Societe Francaise De Greffe De Moelle Et De Therapie Cellulaire (SFGM-TC)
    American Society of Hematology ; 2015
    In:  Blood Vol. 126, No. 23 ( 2015-12-03), p. 4367-4367
    Details
    In: Blood, American Society of Hematology, Vol. 126, No. 23 ( 2015-12-03), p. 4367-4367
    Abstract: Introduction: Acute myeloid leukemia (AML) patients failing to achieve complete remission or relapsing after intensive chemotherapy, have a dismal prognosis. In this setting, allogeneic hematopoietic cell transplantation (HCT) is a curative salvage therapy, but myeloablative conditioning (MAC) transplants are usually associated with high non-relapse mortality (NRM). Promising results have been reported using a sequential treatment approach (SEQ) consisting of cytoreductive chemotherapy, followed by reduced-intensity conditioning (RIC) and prophylactic transfusion of donor lymphocytes. Nevertheless, for young patients with refractory or relapsed AML, there is no definitive evidence to prefer SEQ rather than MAC HCT. The aim of this study, analysing the data from the SFGM-TC, was to compare the results of these two approaches in patients transplanted in AML not in complete remission. Methods: Inclusion criteria: a) HCT performed from January 2006 to December 2013 b) Patient age up to 50 years (y), c) Transplant for refractory or relapsed AML, c) SEQ or MAC regimen d) Matched sibling donor, matched or mismatched unrelated donor. PatientsÕ characteristics: 108 patients (median age: 38 y (range 1-50)) were analysed. Eighty-eight percent of patients were diagnosed with de novo AML and 12% with secondary AML. At diagnosis, 4% of patients were classified favorable, 33% Intermediate-1, 25% intermediate-2, and 38% adverse, according to the European LeukemiaNet (ELN) score. Before transplant, patients received a median of 2 lines of chemotherapy (range 0-3). At transplant, 53% of patients were in primary induction failure (PIF), 43% in relapse, and 4% were never treated and the median of bone marrow (BM) and circulating blast percentages were 19% (range 0-96) and 2% (range 0-93) respectively. Transplant modalities: 60 patients received a SEQ approach (cytoreductive chemotherapy with FLAMSA (N=40) or with clofarabine (N=20) + high-dose cytarabine, followed by RIC combining cyclophosphamide (CY) with 4 Gy total body irradiation (TBI) or with busulfan (BU)) while 48 patients received a MAC regimen (CY combined with 10-12 Gy TBI (N=20) or with BU (N=28)). Forty-one percent of patients were transplanted from a sibling and 59% from an unrelated donor. Stem cell source was peripheral blood in 76% and BM in 24%. Results: MAC and SEQ groups had similar ages, ELN scores, numbers of pre-transplant chemotherapy lines and status at transplant. They only differed from the percentage of circulating blasts at transplant (median 1%, range (0-66) in MAC group vs 8%, range (0-93) in SEQ group, p=0.004) and from the time between diagnosis and transplant (median 164 days, range (62-610) and 239 days range (61-3702) respectively, p=0.036). In univariate analysis, type of conditioning regimen (MAC versus SEQ) did not impact post-transplant outcomes: 2-year overall survival (OS) was 37.2% (95% confidence interval (CI): 23.8-50.7%) in MAC patients vs 32.9% (95%CI: 21.4-44.9%) in SEQ patients (p=0.43); 2-year cumulative incidence of relapse was 56.7% (95%CI: 42.2-71.1%) vs 50.1% (95%CI: 37.2-63%) respectively (p=0.89) and 2-year non-relapse mortality was 14.7% (95%CI: 4.5-25%) vs 16.7% (95%CI: 7.1-26.2%) respectively (p=0.46). Grade II-IV acute graft versus host disease (GVHD) occurred more frequently in patients who received MAC: 66.7% vs 36.7% in the SEQ group (p=0.002), there was also a trend for more chronic-GVHD (41.7% vs 25%, p=0.066). Multivariate analysis identified high number of chemotherapy lines (hazard ratio (HR) 1.66, 95%CI 1.11-2, p=0.013) and high percentage of circulating blasts at transplant (HR 1.01, 95%CI 1.003-1, p=0.011), as factors independently associated with poor OS. Heterogeneity analyses performed for OS identified significant interactions between the type of HCT conditioning and BM blast percentage (p=0.01), or CD34+ cell dose (p=0,04), analysed as categorical variables with cut-offs at medians (20% and 6.106/kg, respectively). Though limited by low patients numbers, subgroup analyses suggested that SEQ HCT conferred a higher risk of death in patients with BM blasts 〉 or = to 20% (HR=1.42), but a lower risk (HR=0.59) with BM blasts 〈 20%, compared to MAC. In conclusion, these data confirm that HCT is a valid salvage therapy for relapsed or refractory AML. In patients up to 50 years, both MAC and SEQ conditioning regimens offer similar outcomes, without increased NRM after MAC transplant. Figure 1. Figure 1. Disclosures Mohty: Janssen: Honoraria; Celgene: Honoraria.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    URL: Article
    DOI: 10.1182/blood.V126.23.4367.4367
    RVK:
    XA 33000
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2015
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 2
    Online Resource
    Online Resource
    Comparison of umbilical cord blood allogeneic stem cell transplantation vs. auto‐ SCT for adult acute myeloid leukemia patients in second complete remission at transplant: a retrospective study on behalf of the SFGM ‐ TC
    Wiley ; 2015
    In:  European Journal of Haematology Vol. 94, No. 5 ( 2015-05), p. 449-455
    Details
    In: European Journal of Haematology, Wiley, Vol. 94, No. 5 ( 2015-05), p. 449-455
    Abstract: This retrospective study considered the outcomes of 181 patients with acute myeloid leukemia ( AML ) transplanted in second complete remission ( CR 2) between January 2005 and April 2012 and who received either a myeloablative autologous stem cell transplant (Auto‐ SCT ; n  = 82; median age: 48 years; median follow‐up: 45 months) or an umbilical cord blood ( UCB ) allogeneic SCT ( n  = 99, median age: 46 years; median follow‐up: 36 months; conditioning regimens: myeloablative n  = 21, reduced n  = 78; single unit n  = 37, double units n  = 62). Although the Auto group showed a significant better prognostic profile at transplant, with longer median interval between diagnosis and time of graft, higher incidence of good‐risk cytogenetics and lower number of previously transplanted patients, 3‐year OS and LFS were similar between both groups (Auto: 59 ± 6% vs. 50 ± 6%, P  = 0.45; and 57 ± 6% vs. 46 ± 6%, P  = 0.37). In multivariate analysis, UCB allo‐ SCT was associated with lower relapse incidence ( HR : 0.3, 95% CI : 0.11–0.82, P  = 0.02), but higher non‐relapse mortality ( NRM ) ( HR : 4.16; 95% CI : 1.46–11.9, P  = 0.008). Results from this large study suggest that UCB allo‐ SCT provides better disease control than auto‐ SCT , which is especially important in the setting of high‐risk disease. However, this disease control advantage is counterbalanced by higher toxicity, highlighting the need for novel approaches aiming to decrease NRM after UCB allo‐ SCT .
    Type of Medium: Online Resource
    ISSN: 0902-4441 , 1600-0609
    URL: Issue
    URL: Article
    DOI: 10.1111/ejh.2015.94.issue-5
    DOI: 10.1111/ejh.12451
    Language: English
    Publisher: Wiley
    Publication Date: 2015
    detail.hit.zdb_id: 2027114-1
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 3
    Online Resource
    Online Resource
    Safety and Efficacy of FLAMSA Regimen Followed by Allogeneic Hematopoietic Stem Cell Transplantation From Related and Unrelated Donors in High Risk Acute Leukemia and MDS Patients: A Study From the Societe Française De Greffe De Moelle Et De Therapie Cellulaire (SFGM-TC) Registry.
    American Society of Hematology ; 2009
    In:  Blood Vol. 114, No. 22 ( 2009-11-20), p. 4335-4335
    Details
    In: Blood, American Society of Hematology, Vol. 114, No. 22 ( 2009-11-20), p. 4335-4335
    Abstract: Abstract 4335 Background Primary induction failure or relapse in AML patients maintains a very poor prognosis despite the cytogenetic stratification and the introduction of new molecules. Nevertheless, allo-HSCT can improve the overall survival of some of these patients, although new strategies are needed especially in conditioning to allow a better outcome in this high risk population of patients. Aims The aim of this analysis was to investigate the safety and efficacy of FLAMSA sequential regimen in patients with high-risk acute leukaemia and MDS, in a multicenter retrospective French study. Methods We analyzed 79 patients, 44 males & 35 females with a median age of 55 years (19-69), there were 50 de novo acute leukaemias, 3 secondary leukaemias and 26 MDS, who underwent allo-HSCT after FLAMSA conditioning [fludarabine (30 mg/m2), high-dose AraC(2 g/m2), and amsacrine (100 mg/m2) from day -12 to -9 + cyclophosphamide (40 mg/kg with related donors, 60 mg/kg with unrelated or mismatched donors) on days -4 and -3, ATG 2.5mg/kg on days -4, -3, and -2 + TBI 4 Gy on day -5 (n=42) or Busilvex 3.2 mg/kg on days -4 & -5(n=37)] who were reported to the Societe Francaise Greffe de Moelle et de Therapie Cellulaire (SFGM-TC) registry. Thirteen patients had undergone previous HSCT (10 allogeneic and 3 autologous). The disease status at transplantation were: 19 (24%) of the patients in primary induction failure (PIF) or refractory disease, 14 (17,7%) in second relapse, 25 (32%) in early relapse, 8 (10%) in untreated disease and 13 (16.3%) in progressive disease. Thirty-four patients were transplanted from HLA identical siblings and 45 from unrelated donors. Sixty four grafts were PBSC, 5 bone marrow and 8 cord blood cells. Results After HSCT, 73 patients engrafted (6 non valuable early deaths) with a median time to neutrophil recovery of 16 days (8-41). There were 31 aGVHD (grade I: n=10, grade II: n=12, grade III: n=4 and grade IV: n=5) and 18 chronic GvHD (10 limited, 5 extensive and 3 unclassified). At the last follow-up, 32 patients are alive, after a median follow-up of 4.2 months, the probability of OS for the whole population at 2 years was 22.8% with 43.8% for untreated patients, 13.8% for patient in relapse, it was 47% for progressive and 23% for PIF patients. The univariate analysis showed a better significant OS according to 4 factors: disease status (untreated patients) (p= 0.04), kind of disease (p 〈 0.001); HLA matching (p=0.03) and HSC source (PBSC) (p=0.004) without any significant impact of age, sex-matching, CMV matching, ABO matching, conditioning regimen (TBI or Busilvex) and interval between diagnosis and transplantation. The multivariate analysis using Cox regression model showed the significant impact of 2 factors on OS: kind of disease; HR=0.284 [0.09-093] (p=0.03) and minor ABO incompatibility HR=2.55 [0.99-6.61] (p=0.05). The cumulative incidence of relapse and TRM at 6 months, 1 & 2 years were: 33%, 39.2% & 40.5% and 20.2%, 21% & 21.5% respectively without any TRM in the untreated group. The multivariate analysis showed also the significant impact of disease status on TRM (p 〈 0.001), and minor ABO incompatibility on relapse HR=5.35 [1.81-15-81] (p=0.002). The estimated cumulative incidence of death from leukaemia at 1 and 2 years from transplant was 62,7% (95% CI, 48,4%-73,1%) and 72,2% (95% CI, 57,3%-87,8%). Conclusion Our study showed a total OS of 23% at 2 years with a better survival in the untreated patients (44%) and progressive patients (47%); a worse survival for the PIF and relapsed patients group (23% & 12% respectively). When comparing to the German study, we observed similar results regarding TRM and relapse incidence, the only difference was the leukemia mortality with a higher rate in our patients which could be explained with the different relapse treatment. Disclosures: No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    URL: Article
    DOI: 10.1182/blood.V114.22.4335.4335
    RVK:
    XA 33000
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2009
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 4
    Online Resource
    Online Resource
    Gene Mutations and Minimal Residual Disease (MRD) As Predictors of Remission Duration in Adults with Core Binding Factor (CBF) Acute Myeloid Leukemia (AML) Treated with High-Dose Cytarabine (HDAC) - First Results of the Prospective French Intergroup CBF-2006 Trial
    American Society of Hematology ; 2011
    In:  Blood Vol. 118, No. 21 ( 2011-11-18), p. 410-410
    Details
    In: Blood, American Society of Hematology, Vol. 118, No. 21 ( 2011-11-18), p. 410-410
    Abstract: Abstract 410 Background. CBF-AML is a favorable AML subset cytogenetically defined by t(8;21) or inv(16)/t(16;16) rearrangements, respectively responsible for RUNX1-RUNX1T1 (CBFa) or CBFB-MYH11 (CBFb) gene fusion. Nonetheless, relapse incidence may reach 30–40% in these patients. Even if not yet prospectively validated, early MRD monitoring based on chimeric fusion gene transcript quantification by RQ-PCR may help to define patients at higher risk of relapse. Detection of activating KIT and FLT3 gene mutations has also been retrospectively associated with higher relapse rate in these patients. The French CBF-2006 trial (NCT00428558) aimed to prospectively evaluate both markers as predictors of remission duration in homogeneously treated patients. Methods. Patients (18–60y) with newly diagnosed CBF-AML were eligible. All were studied for KIT exon 8/17, FLT3-ITD, FLT3-D835, N-RAS and K-RAS mutations. They were randomized to receive timed-sequential or standard induction. Timed-sequential induction was cytarabine (AraC) 500 mg/m2 CI D1-3 and daunorubicine (DNR) 60 mg/m2 D1-3, followed by AraC 1 g/m2/12h D8-10 and DNR 35 mg/m2 D8-9. Standard arm was AraC 200 mg/m2 CI D1-7 and DNR 60 mg/m2 D1-3, followed by the second sequence at D16-18 only in case of persistent bone marrow (BM) blasts at D15. Patients in first complete remission (CR1) received 3 HDAC consolidation cycles with AraC 3 g/m2/12h D1/3/5. Fusion gene expression was quantified at baseline and before each HDAC cycle (MRD1, MRD2, MRD3) by the 100 × fusion gene/cABL ratio. Patients not reaching a 3-Log ratio reduction at MRD2 were offered allogeneic stem cell transplantation (SCT) in CR1 if they had an HLA-identical donor or could enter a single-agent dasatinib sub-study (see Boissel et al., this meeting). Results. Among the planned 200 patients randomized, 198 met eligibility criteria (96 CBFa and 102 CBFb, compared in Table 1). Overall, incidences of KIT, RAS, FLT3-D835 and FLT3-ITD mutations were 21%, 29%, 10% and 6%, respectively. Patients with KIT and FLT3-D835 mutations had higher WBC (P=0.04 and 0.02) and BM blast percentage (P=0.0004 and 0.05). Those with RAS mutations had lower BM blast percentage (P=0.01) and baseline transcript ratio (P=0.001). Overall, 196 patients reached CR1 and 55 relapsed. At 3 years, probabilities of durable remission, disease-free (DFS) and overall survival from CR were 64%, 61% and 84%, respectively, without differences between the CBF subsets or induction arms. Fifty-five patients did not reach the 3-Log MRD2 reduction (18 CBFa and 37 CBFb, P=0.006), 9 receiving SCT in CR1. Poor MRD2 response correlated with age (P=0.01), WBC (P=0.04), KIT mutations (P=0.04), and initial transcript ratio (P=0.004). Among the characteristics listed in Table 1, shorter remission duration was associated with high WBC (P=0.011), high BM blast percentage (P=0.062), del(9q) (P=0.041), KIT mutation (P=0.048), FLT3-D835 mutation (P=0.077), high initial transcript ratio (P=0.053), and 〈 3-Log MRD2 reduction (P=0.006) in univariate analysis stratified by CBF subtype and treatment arm. In multivariate analysis, the three latter factors, but not KIT mutations, remained independently predictive of shorter remission duration and DFS (P= 0.014, 0.033, 0.002 and 0.001, 0.012, 0.005, respectively). Censoring patients receiving SCT in CR1 yielded similar results. Conclusions. This prospective study of 198 CBF-AML patients homogeneously treated with HDAC revealed significant correlations between initial characteristics and response to therapy. Prognostic analysis did not find that KIT mutations had independent impact on outcome, which was rather influenced by baseline fusion transcript ratio and post-consolidation MRD reduction (reminiscent of Schnittger et al. 2003), and FLT3-D835 mutation. Ongoing pan-genomic analyses might help to further dissect CBF-AML heterogeneity. Disclosures: No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    URL: Article
    DOI: 10.1182/blood.V118.21.410.410
    RVK:
    XA 33000
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2011
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 5
    Online Resource
    Online Resource
    Double Cord Blood Cell (CBC) Hematopoietic Stem Cell Transplantation after Standard or Reduced Intensity Conditioning: Report of the SFGMTC Registry.
    American Society of Hematology ; 2008
    In:  Blood Vol. 112, No. 11 ( 2008-11-16), p. 1972-1972
    Details
    In: Blood, American Society of Hematology, Vol. 112, No. 11 ( 2008-11-16), p. 1972-1972
    Abstract: This analysis concerned 164 allogeneic HSCT after standard (Std) or reduced intensity conditioning (RIC) using double cord blood cells (CBC), reported to the SFGM-TC registry. There were 57 females (F) and 107 males (M) with a median age of 39.5 years (18–66). The diagnosis pretransplant were acute leukaemia: 93 (56 AML and 37 ALL), MDS: 9, MPS: 9 (CML: 4), CLL: 5, NHL: 18, HD: 7, MM: 13, AA: 7, other diseases: 3 (2 inborn errors and 1 solid tumour). The median interval between diagnosis and HSCT was 20.6 months (2.6–385.5). Among 154 evaluated patients (pts), disease status prior conditioning were 92 CR (CR1: 45, CR 2: 34, & gt;CR2: 12 and 1 non classified), 21 PR, 21 stable diseases (SD) (SD: 6, AA: 6, inborn errors: 2, CML in CP: 3, myelofibrosis: 2 and MDS: 2), 22 progressive diseases (PD) (PD: 4, relapses: 10 and refractory diseases: 8), 8 pts were not documented. Among 158 pts documented, 49 (31%) were completely sex matched and 109 (69%) sex mismatched [72 CBC1+2 (F+F or F+M) for a M recipient and 37 CBC1+2 (M+M or M+F) for a F recipient]. Among 158 documented, 42% of recipients, 37% of CBC1 and 38% of CBC2 were CMV+; there was a complete ABO compatibility between the 2 CBC and the recipient in 38 cases, 1 or 2 minor incompatibilities in 40 cases and almost 1 major incompatibility in 80 cases. For HLA matching, we distinguished 3 groups: group1 [n=78 (HLA compatibility at least 4/6 between recipient and CBC1+2) and between CB1 and CB2 including total HLA DRB1 matching)] , group 2 [n=55 (HLA compatibility at least 4/6 between recipient and CBC1+2) considering neither HLA compatibility between CBC1-CBC2 nor HLA DRB1 matching)] and group3 [n=25 (all others)] . At harvesting, the median number of total nucleated cells (TNC) (x107/kg) was 4.67(1.6–12.2), the CD34+ (x105/kg) 1.8 (0.3–10.8), the CFU-GM (x104/kg) 3.67 (0.94–25), and after thawing 3.24(0.58–12), 1.4(0.2–9.2) and 2(0.27–16.4) respectively. The TNC threshold number was set to 5x107/kg because more than 96% of pts received more than 3x107/kg. Among 135 documented, 26 (19%) received Std conditioning and 109 (81%) RIC. After transplantation, 129 pts (96%) engrafted with 86% (80–92) of neutrophil recovery at day 60 with no significant difference according to TNC ( & lt;5x107/kg: 88%, ≥ 5 x107/kg: 90%; p=0.28) and HLA matching (group1: 86.6%, group2: 89.6% and group3: 83.3%; p=0.81). Eighty-four pts developed an AGVHD: gr I: 20 and ≥ gr II: 60 (35 gr II, 16 gr III and 4 grade IV), 4 patients were not classified. At day 90, the cumulative incidence of AGVHD grI was 10.4%(5–16), gr ≥ II: 42%(33–51)[grII: 24%(16.5–32), grIII-IV: 18%(11–25)]. Moreover, we observed for AGVHD gr ≥ II according to HLA typing and TNC: group1: 41%(28–54), group2: 46%(31–60) and group3: 33%(8–58); TNC & lt;5x107/kg: 38%(25–51) and TNC & gt;5.107/kg: 46%(32–60). Twenty-one pts presented a chronic GVHD (9 limited and 12 extensive) and the cumulative incidence at 1 year was 13.7%(4–24) for limited and 20%(9–21) for extensive. With a median follow-up of 7.3 months, the probability of 1-year and 2-year overall survival and disease-free survival were 49.6% (40–61.5) and 38% (27–54), 43% (33.5–54.5) and 36% (25–51) respectively. The probabilities of OS, NRM and RM according to TNC, disease status pre-transplant, HLA matching and sex matching are shown in Figure 1 and Table1.The multivariate analysis showed a significant impact of 2 factors on OS: disease status PD vs CR: HR=6.16 (1.87–20.25) (p=0.002); HLA matching group2 vs group1: HR=0.29 (0.11–0.82) (p=0.01), and 3 significant factors on DFS: sex-matched HR=0.29 (0.09–0.94) (p=0.03), sex-mismatched (F recipient) HR=0.15 (0.04–0.61) (p=0.008) and HLA matching (group 2 vs group1) HR=0.32(0.11–0.88) (p=0.02).A refined chimerism analysis is ongoing and will be presented. In conclusion, this large retrospective analysis showed that the quantitative objective of double cord blood use for allogeneic HSCT is achieved (only 4% had received & lt; 3x107/kg TNC) with no further significant impact of TNC number on OS, NRM and RM. As usual in other types of allogeneic HSCT, we demonstrated the significant impact of disease status before transplantation on transplant outcome. Finally, the most interesting point was the better results observed in group 2 but which needs more precise analysis in the future. Table 1. Probability of OS, NRM, RM according to different variables. Probability of OS Probability of NRM Probability of RM Whole population (cummulative 1 year) 49.6%(40–61.5) 49.7%(39–60) 7.5%(2–17) TNC TNC & lt; 5 × 107/kg 50%(36.6–68.5)) 47%(32–62) 8%(0–16) TNC ≥ 5 × 107/kg 44.5%(29.6–67) 56.5%(38.5–74.5) 9.5%(0–20) Disease status pre-transplant CR 51%(38–68) PR 54%(31–92.5) SD 75%(43–100) PD relapse 35.5%(18–70) HLA compatibility Group 1: 4/6 or more for all(2/2 for DRBI) 34%(21–54) 62%(46–78) 10%(3–20) Group 2: 4/6 or more for R-CB1 and R-CB2 61%(45–81) 39%(21–57) 2%(0–6) Group 3: Others 61.6%(42–90) 42.5%(19–66) 10%(0–24.5) Sex matching M recipient with sexmismatch 35%(22–57) 63%(46–79) 8%(2–14) Sexmatch 61%(45–82) 43%(23.5–63) 4.5%(0–13.5) F recipient with sexmismatch 54%(36.5–80)) 42%(24–62) 9%(0–22) Figure 1: Probability of OS according to different HLA groups Figure 1:. Probability of OS according to different HLA groups
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    URL: Article
    DOI: 10.1182/blood.V112.11.1972.1972
    RVK:
    XA 33000
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2008
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 6
    Online Resource
    Online Resource
    Double umbilical cord blood transplantation for hematological malignancies: A long-term analysis from the SFGM-TC registry
    Elsevier BV ; 2013
    In:  Experimental Hematology Vol. 41, No. 11 ( 2013-11), p. 924-933
    Details
    In: Experimental Hematology, Elsevier BV, Vol. 41, No. 11 ( 2013-11), p. 924-933
    Type of Medium: Online Resource
    ISSN: 0301-472X
    URL: Article
    DOI: 10.1016/j.exphem.2013.05.297
    RVK:
    XA 42470
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2013
    detail.hit.zdb_id: 2005403-8
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 7
    Online Resource
    Online Resource
    CloB2A2 Reduced-Intensity Conditioning (RIC) Regimen Prior to Allogeneic Stem Cell Transplantation Provides Significant Better Survival Compared to FB2A2 RIC Regimen in Adults with Acute Myeloid Leukemia (AML): A Study on Behalf of the SFGM-TC
    American Society of Hematology ; 2015
    In:  Blood Vol. 126, No. 23 ( 2015-12-03), p. 1908-1908
    Details
    In: Blood, American Society of Hematology, Vol. 126, No. 23 ( 2015-12-03), p. 1908-1908
    Abstract: Purpose: The FB2A2 (fludarabine, intermediate doses of busulfan and ATG) reduced-intensity conditioning (RIC) regimen is considered as a standard RIC regimen in many centers worldwide. Recently, we have reported the prospective good results of a clofarabine-busulfan containing RIC regimen (CloB2A2) in adults with high-risk acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS) in complete remission (CR) at time of transplant (Chevallier et al, Haematologica, 2014). Thus, this regimen may prove to be superior to the FB2A2 regimen in patients with AML/MDS. Patients and Methods: The aim of this study was to compare outcomes between adult AML/MDS patients who have received, between 2009 and 2015, in 26 French centers, either a FB2A2 RIC regimen (n=170, male 61%, median age: 58 years, AML 86%, CR1 79%) or the CloB2A2 RIC regimen (n=39, including the 16 cases treated within the prospective trial mentioned above, male 62%, median age: 61 years, AML 62%, CR1 64%). The FB2A2 and CloB2A2 regimens consisted of either 30 mg/m²/day Fludarabine for 5 days or 30mg/m²/day Clofarabine for 4 or 5 days, each combined with 3.2 mg/kg/day Busulfan for 2 days and 2.5 mg/kg/day Anti-thymocyte globulin (ATG, Thymoglobuline) for 2 days. As GVHD prophylaxis, cyclosporine (CsA) alone was used in case of related donor in both groups, and for the 16 CloB2A2 patients treated within the prospective trial, while CsA+ MMF were used in case of unrelated donors. The two groups were not statistically different in term of gender, median age and performans status at transplant, median white blood count at diagnosis, median time between diagnosis and transplant, type of donors or cytogenetics for AML patients. Conversely, there were more AML patients (86% vs 62%, p=0.0004) and more patients in CR1 (79% vs 64%, p=0.04) in the FB2A2 group. Also, CloB2A2 patients were transplanted more recently (median year of transplant: 2014 vs 2011, p 〈 0.0001). Results: All patients engrafted, except one in the FB2A2 group. Median time of neutrophils recovery was similar between both groups (FB2A2: 17 days vs CloB2A2: 18 days, p=0.10). With a median follow-up of 28 and 14 months in the FB2A2 and the CloB2A2 groups, respectively, 2-year overall survival (OS) were 59% (51.4-66.7) for the former vs 77% (62.8-91.1) for the latter, p=0.07, 2-year leukemia-free survival (LFS) were 52.7% (44.9-60.4) vs 64% (48.1-79.9), p=0.23, 2-year relapse incidence were 31.1% (24.2-38.4) vs 27.5% (14-42.9), p=0.58, 2-year non relapse mortality were 16.2% (5.8-31.3) vs 8.5% (2.1-20.7), p=0.26 and 2-year chronic GVHD were 13.8% (8.3-20.5) vs 23.9% (8.1-44.2), p=0.12. Incidences of grade 2-4 or grade 3-4 acute GVHD were similar between both groups: FB2A2 22% vs CloB2A2 23%, p=0.86,and 8% vs 3%, p= 0.31. In multivariate analysis, FB2A2 RIC regimen was significantly associated with lower OS and LFS (HR: 2.45; 95%CI: 1.08-5.55, p=0.03; and HR: 2.32; 95%CI: 1.12-4.79, p=0.02) contrary to CR1 status which was associated with significant higher survivals (HR: 0.48; 95%CI: 0.28-0.83, p=0.008 and HR: 0.42; 95%CI: 0.25-0.70, p=0.001). MDS (HR: 1.88; 95%CI: 1.03-3.43, p=0.03) and higher WBC at diagnosis ( 〉 median) (HR: 1.76; 95%CI: 1.10-2.82, p=0.01) were also significantly associated with lower LFS. However, when considering AML and MDS patients separately, benefit of CLOB2A2 RIC regimen appears to be restricted to AML patients (2-year OS FB2A2: 58.1% vs CloB2A2: 80.2%; HR: 2.45; 95%CI: 1.08-5.55, p=0.03; and 2-year LFS FB2A2: 53.6%, vs CloB2A2: 76.9%; HR: 2.32; 95%CI: 1.12-4.79, p=0.02). Conclusion: Thisretrospective comparison suggests thattheCloB2A2 RIC regimen can likely provide a higher survival compared to the use of a FB2A2 RIC regimen for AML patients. A prospective phase 3 randomized study is warranted. Disclosures Deconinck: JANSSEN: Other: Travel for international congress; NOVARTIS: Other: Travel for international congress; ALEXION: Other: Travel for international congress; ROCHE: Research Funding; PFIZER: Research Funding; CHUGAI: Other: Travel for international congress; LFB loboratory: Consultancy. Mohty:Janssen: Honoraria; Celgene: Honoraria.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    URL: Article
    DOI: 10.1182/blood.V126.23.1908.1908
    RVK:
    XA 33000
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2015
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 8
    Online Resource
    Online Resource
    Reduced-Intensity Conditioning (RIC) Allogeneic Stem Cell Transplantation (allo-SCT) for Patients Aged ≥60 Years: a Retrospective Study of 629 Patients From the Societe Française De Greffe De Moelle Et De Therapie Cellulaire (SFGM-TC).
    American Society of Hematology ; 2009
    In:  Blood Vol. 114, No. 22 ( 2009-11-20), p. 194-194
    Details
    In: Blood, American Society of Hematology, Vol. 114, No. 22 ( 2009-11-20), p. 194-194
    Abstract: Abstract 194 Age has been previously demonstrated to be a major prognostic factor for outcome after allo-SCT. Many centres usually use an age threshold around 50 years for considering a standard myeloablative conditioning regimen, and around 65 years for considering a RIC regimen. The aim of this report was to assess the outcome of 629 patients aged ≥60 years who received RIC allo-SCT, with a special emphasis on the comparison of the outcome of patients aged 60–65 years (y.) and patients aged 〉 65 y. Between 1998 and 2008, 629 patients with different haematological diseases were treated with RIC allo-SCT, and reported to the SFGM-TC Registry. This series included 417 males (66%) and 212 females (34%). The median age for the whole cohort was 62 (range, 60–71) y. 378 patients (55%) were diagnosed with a myeloid malignancy, while 240 (38%) had lymphoid malignancies, and 11 (2%) had other non-classifiable diseases. 478 patients (76%) had high risk disease features, and 151 (24%) had a standard risk disease. 386 patients (61%) received allo-SCT from an HLA-matched related donor, while 199 patients (32%) received the graft from a matched-unrelated donor, and 44 (7%) from mismatched donors. Peripheral blood stem cells were used in 83% of patients (n=520). The conditioning regimen consisted of Fludarabine and Busulfan in 280 cases (44.5%), Fludarabine and low dose TBI in 150 cases (24%). The remaining 199 patients (32%) received other so-called RIC protocols. With a median follow-up of 9 (range, 1–90) months after allo-SCT, grade II-IV and grade III-IV acute GVHD occurred at a median of 31 days after allo-SCT in 29% (n=182) and 12% (n=76) of patients, respectively. Chronic GVHD was observed in 145 patients (23%; limited: n=67; extensive: n=72; unknown stage: n=6). At last follow-up, 347 patients (55%) were still alive (of whom 205 in CR; 65%): 147 patients (16%) died of disease progression, and 180 patients died of transplant-related causes (TRM: 29%). The Kaplan-Meier (KM) estimates of overall survival (OS) at one and 2 years were 57% (95%CI, 53–62%) and 47% (95%CI, 42–52%), respectively. In order to assess the applicability of RIC allo-SCT to the older age group, we next compared the outcome of patients aged from 60 to 65 y. (n=516) and those aged 〉 65 y. (n=113; median 66 y.; range, 65–71). Except for age, in univariate analysis, these 2 groups were not statistically different in terms of demographic, disease or transplant characteristics. Overall, the median time to ANC 〉 500/μL was 18 (range, 1–102) days, with this being comparable between the younger (60–65 y.) and elderly ( 〉 65 y.) age groups (p=0.19). The incidences of grade II-IV and grade III-IV acute GVHD were comparable between both groups (60–65 y.: 29% vs. 〉 =65y.: 30%, p=NS; and 12% vs. 12%; p=NS). The TRM incidence was 29% in the younger group vs. 27% in the older group (p=NS). The KM estimates of OS at 1 and 2 years were 58% (95%CI, 53–62%) and 47% (95%CI, 42–52%) in the younger age group and 55% (95%CI, 44–65%) and 48% (95%CI, 37–60%) in the older age group (p=NS). In a Cox multivariate analysis accounting for all relevant factors, age 〉 65 y. was not found to be a statistically significant factor associated with worsened survival. Despite its retrospective nature and the inherent selection biases, this data support the use of RIC-allo-SCT in patients 〉 60 y. Moreover, outcome of patients aged 〉 65 y. appears to be comparable to that of patients aged 60–65 y. Physiologic aging is likely more important than chronologic aging. With the refinement of comorbidities scoring systems, age per se (at least up to 70 y.) should not be a contraindication to perform RIC allo-SCT and this should be tested prospectively. Disclosures: No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    URL: Article
    DOI: 10.1182/blood.V114.22.194.194
    RVK:
    XA 33000
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2009
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 9
    Online Resource
    Online Resource
    Reduced-Intensity Conditioning before Allogeneic Hematopoietic Stem Cell Transplantation in Patients Over 60 Years: A Report from the SFGM-TC
    Elsevier BV ; 2012
    In:  Biology of Blood and Marrow Transplantation Vol. 18, No. 2 ( 2012-02), p. 289-294
    Details
    In: Biology of Blood and Marrow Transplantation, Elsevier BV, Vol. 18, No. 2 ( 2012-02), p. 289-294
    Type of Medium: Online Resource
    ISSN: 1083-8791
    URL: Article
    DOI: 10.1016/j.bbmt.2011.07.013
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2012
    detail.hit.zdb_id: 3056525-X
    detail.hit.zdb_id: 2057605-5
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 10
    Online Resource
    Online Resource
    Medication non‐adherence after allogeneic hematopoietic cell transplantation in adult and pediatric recipients: a cross sectional study conducted by the Francophone Society of Bone Marrow Transplantation and Cellular Therapy
    Wiley ; 2021
    In:  Fundamental & Clinical Pharmacology Vol. 35, No. 2 ( 2021-04), p. 435-445
    Details
    In: Fundamental & Clinical Pharmacology, Wiley, Vol. 35, No. 2 ( 2021-04), p. 435-445
    Abstract: Medication non‐adherence (NA) after allogeneic hematopoietic cell transplantation (allo‐HCT) can lead to serious complications. This study assesses NA in French adult and pediatric recipients and identifies factors associated with NA. In accordance with the EMERGE and STROBE guidelines, a cross sectional multicentric survey was conducted. We used a self‐reported questionnaire that was adapted to adults and pediatrics and that could provide a picture of all three phases of medication adherence: initiation, implementation, persistence. We enrolled 242 patients, 203 adults (mean age: 51 years old, 50.7% male) and 39 children (mean age: 9 years old, 56.4% female). Reported NA was estimated at about 75% in both populations, adults and pediatrics. In adults, the univariate analysis showed that patients less than 50 years old ( P  = 0.041), (i) treated with cyclosporine ( P  = 0.02), (ii) treated with valacyclovir/acyclovir ( P  = 0.016), and (iii) experiencing side effects ( P  = 0.009), were significantly more non‐adherent. In multivariate analysis, only recipient age was significantly associated to NA ( P  = 0.05). The limited size of the pediatric population did not allow us to draw any statistical conclusion about this population. To the best of our knowledge, this is the first study in France on NA in allo‐HCT recipients. Our results highlight the age factor as the only factor related to NA. Further studies are needed to confirm our observations and refine results in pediatric populations, currently most at risk of medication NA.
    Type of Medium: Online Resource
    ISSN: 0767-3981 , 1472-8206
    URL: Issue
    URL: Article
    DOI: 10.1111/fcp.v35.2
    DOI: 10.1111/fcp.12593
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2006242-4
    SSG: 15,3
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...