Comparisons of myeloablative and reduced intensity or nonmyeloablative conditioning in adult patients with AML
| Study . | Patient population . | Sample size . | LFS . | OS . | Other comments . |
|---|---|---|---|---|---|
| Aoudjhane et al, 2005104 ; Multicenter, EBMT | AML, > 50 y, MSD only | 722, RIC = 315, MAC = 407 | Similar | Similar | Decreased acute GVHD, chronic GVHD, and TRM, but increased relapse with RIC |
| Alyea et al, 200670 ; single center, Boston | AML/MDS, 21-70 y, MRD and URD donors | 136, (AML, 82) RIC = 39, MAC = 97 | Similar | Similar | Decreased TRM, and increased relapse with RIC |
| Scott et al, 2006102 ; single center, Seattle | MDS/sAML with previous MDS, 40-72 y, MRD and URD | 150, (AML, 55) NMA = 38, MAC = 112 | Similar | Similar | No difference in relapse/TRM |
| Shimoni et al, 200672 ; single center, Tel-Hashomer | AML/MDS, 17-70 y, MRD and URD | 112, (AML, 56) RIC = 67, MAC = 45 | Similar | Similar | Similar outcomes for patients in remission at HCT, inferior outcomes of patients with active disease treated with RIC |
| Flynn et al, 2007103 ; single center, Minnesota | AML/MDS, 19-69 y, MRD and URD (included UCB grafts) | 219, (AML, 160) RIC = 32, MAC = 187 | Similar | Similar | Similar TRM, but increase in relapse with RIC |
| Ringden et al, 2009101 ; EBMT multicenter | AML, 16-76 y, URD transplants only | 1555, RIC = 401, MAC = 1154 | Similar | Not reported | Reduced NRM in ≥50 y, and increased relapse in patients <50 y with RIC. |
| Lim et al, 2010106 ; EBMT, multicenter | MDS/sAML with previous MDS, ≥ 50 y, MRD and URD | 1333, (AML, 334), RIC = 833, MAC = 500 | Not reported | Similar | Increased relapse, and decreased TRM with RIC |
| Khabori et al, 201099 ; single center, Toronto | AML/MDS, 40-60 y, MRD and URD transplants | 101, (AML, 77), RIC = 39, MAC = 62 | Similar | Similar | Poor outcome in patients with high-risk disease biology attributable to higher relapse rate |
| Luger et al, CIBMTR105 , multicenter | AML/MDS, 18-70 y, MRD and URD | 5179, RIC/NMA = 1448, MAC = 3731 | Similar between MAC vs RIC, inferior for NMA | Similar between MAC vs RIC, More relapse with NMA | Late TRM negated any advantage offered by RIC or NMA |
| Study . | Patient population . | Sample size . | LFS . | OS . | Other comments . |
|---|---|---|---|---|---|
| Aoudjhane et al, 2005104 ; Multicenter, EBMT | AML, > 50 y, MSD only | 722, RIC = 315, MAC = 407 | Similar | Similar | Decreased acute GVHD, chronic GVHD, and TRM, but increased relapse with RIC |
| Alyea et al, 200670 ; single center, Boston | AML/MDS, 21-70 y, MRD and URD donors | 136, (AML, 82) RIC = 39, MAC = 97 | Similar | Similar | Decreased TRM, and increased relapse with RIC |
| Scott et al, 2006102 ; single center, Seattle | MDS/sAML with previous MDS, 40-72 y, MRD and URD | 150, (AML, 55) NMA = 38, MAC = 112 | Similar | Similar | No difference in relapse/TRM |
| Shimoni et al, 200672 ; single center, Tel-Hashomer | AML/MDS, 17-70 y, MRD and URD | 112, (AML, 56) RIC = 67, MAC = 45 | Similar | Similar | Similar outcomes for patients in remission at HCT, inferior outcomes of patients with active disease treated with RIC |
| Flynn et al, 2007103 ; single center, Minnesota | AML/MDS, 19-69 y, MRD and URD (included UCB grafts) | 219, (AML, 160) RIC = 32, MAC = 187 | Similar | Similar | Similar TRM, but increase in relapse with RIC |
| Ringden et al, 2009101 ; EBMT multicenter | AML, 16-76 y, URD transplants only | 1555, RIC = 401, MAC = 1154 | Similar | Not reported | Reduced NRM in ≥50 y, and increased relapse in patients <50 y with RIC. |
| Lim et al, 2010106 ; EBMT, multicenter | MDS/sAML with previous MDS, ≥ 50 y, MRD and URD | 1333, (AML, 334), RIC = 833, MAC = 500 | Not reported | Similar | Increased relapse, and decreased TRM with RIC |
| Khabori et al, 201099 ; single center, Toronto | AML/MDS, 40-60 y, MRD and URD transplants | 101, (AML, 77), RIC = 39, MAC = 62 | Similar | Similar | Poor outcome in patients with high-risk disease biology attributable to higher relapse rate |
| Luger et al, CIBMTR105 , multicenter | AML/MDS, 18-70 y, MRD and URD | 5179, RIC/NMA = 1448, MAC = 3731 | Similar between MAC vs RIC, inferior for NMA | Similar between MAC vs RIC, More relapse with NMA | Late TRM negated any advantage offered by RIC or NMA |
CIBMTR indicates Center for International Blood and Marrow Transplant Research; EBMT, European Group for Blood and Marrow Transplantation; GVHD, graft versus host disease; HCT, hematopoietic cell transplantation; LFS, leukemia-free survival; MAC, myeloablative conditioning; MRD, matched related donor; MUD, matched unrelated donor; NMA, nonmyeloablative, NRM, nonrelapse mortality; OS, overall survival; RIC, reduced-intensity conditioning; sAML, secondary AML; TRM, treatment-related mortality; UCB, umbilical cord blood; and URD, unrelated donor.