In a nutshell
This study aimed to compare the effectiveness of myeloablative conditioning and reduced intensity conditioning before hematopoietic stem cell transplant in acute myeloid leukemia patients.
This study concluded that myeloablative conditioning was more effective than reduced intensity conditioning.
Some background
A hematopoietic stem cell transplant (HSCT) is the standard treatment option for acute myeloid leukemia (AML). It involves removing stem cells from a donor and transferring them into the AML patient. Stem cells can produce any cell type and help to restore the immune system.
Conditioning regimens are treatments carried out before HSCT to ensure the transplant is successful. Standard myeloablative conditioning (MAC) involves intense chemotherapy and radiation and leads to destruction of bone marrow. Reduced intensive conditioning (RIC) uses less intense chemotherapy and radiation than MAC.
It was unknown which conditioning regimen was more effective for AML patients who were to receive HSCT.
Methods & findings
This study involved 272 AML patients who were due to undergo HSCT. 49% received MAC followed by HSCT and 51% received RIC followed by HSCT. The overall survival (time from treatment until death from any cause) was measured 18 months after the patients started treatment. Relapse free survival (time from treatment until cancer returns) and treatment related mortality (death due to treatment) were also measured.
The overall survival for the RIC group was 67.7% compared to 77.5% for the MAC group.
Treatment related mortality for the RIC group was 4.4% compared to 15.8% for the MAC group.
Relapse free survival at 18 months was 47.3% for the RIC group compared to 67.8% for the MAC group.
The bottom line
This study concluded that MAC is more effective and should be used for AML patients who will undergo HSCT.
What’s next?
Consult your physician about the best conditioning regimen before HSCT for you.
Published By :
Journal of clinical oncology
Date :
Apr 10, 2017
