Summary of selected reduced-intensity allograft studies that include patients with myelodysplastic syndrome (MDS).*
| Author (Study) # Patients . | Disease . | Median Age . | Conditioning & Stem Cell Source . | Median Follow-Up . | GVHD . | NRM . | DFS . | OS . | Comments . |
|---|---|---|---|---|---|---|---|---|---|
| Abbreviations: aGVHD, acute graft-versus-host disease (grade in parentheses); cGVHD, chronic GVHD; ecGVHD, extensive cGVHD; ATG, antithymocyte globulin; NRM, nonrelapse mortality; CDA, 2-chloro-deoxyadenosine; DFS, disease-free survival; OS, overall survival, MTX, methotrexate | |||||||||
| * Number of patients in each diagnostic group is in parentheses | |||||||||
| Giralt (1997)31 15 patients | AML (13); MDS (2) | 59 years (27–71) | fludarabine 120 mg/m2, idarubicin 12 mg/m2, cytarabine 8 g/m2 or melphalan 140 mg/m2; OR cda 60mg/m2, cytarabine 5g/m2 [HLA identical related donor, or 1Ag mismatch] | 100 days (34–175) (survivors) | aGVHD (I) 7%; aGVHD (II) 14%; cGVHD 0% | 33% at reporting | — | — | Median survival 78 days (0–175) |
| Slavin (1998)17 26 patients | MDS (1); AML (8) | 34 years (1–61) | fludarabine 180 mg/m2, busulphan 8 mg/kg, ATG 80 mg/kg; cyclosporine [HLA-matched siblings] | 8 months | aGVHD (III–IV) 25% | 15% (8 months) | 80.7% (8 months) | 85% (8 months) | 2 AML died of GVHD |
| Childs (1999)32 15 patients | RAEB-t (2); CMML (1); non-MDS (12) | 50 years (23–68) | fludarabine 125 mg/m2, cyclophosplamide 120 mg/kg, cyclosporine; [HLA-matched siblings] | 200 days (121–409) (survivors) | aGVHD (II–IV) 60%; cGVHD 27% | 14% (at median follow-up) | 40% (at median follow-up) | 53% (at median follow-up) | 1 MDS patient in CR at median follow-up |
| McSweeney (2001)33 45 patients | RAEB-t (1); AML (10) | 56 years (31–72) | TBI 200 cGy; cyclosporine; mycophenolate [HLA-matched siblings] | 417 days (310–759) (survivors) | aGVHD (II–III) 47% | 6.7% (at median follow-up) | 53% (at median follow-up) | 66.7% (at median follow-up) | RAEB-t progressive disease; 4:10 AML in CR |
| Martino (2001)1976 patients | MDS (12) | 53 years (18–66) | fludarabine 150 mg/m2; melphalan 140 mg/m2 or busulphan 10 mg/kg; cyclosporine, short course MTX [HLA-matched siblings] | 287 days for MDS | aGVHD (II–IV) 32% (100day); ecGvHD 43% (1yr) | 1:12 MDS patients at reporting | 6:12 MDSpatients atreporting | 11:12 MDS patients at reporting | |
| Corradini (2002)18 45 patients | AML (5); RAEB-t (6); | 49 years (20–68) | thiotepa 20 mg/kg; cyclophosphamide 60 mg/kg; fludarabine 60 mg/m2; cyclosporine; [HLA-matched siblingsor 1Ag mismatched related] | 385 days (24–820) | aGVHD (II–IV) 47%; aGVHD (III–IV) 13%; | 13% | — | 53% | 3 AML and 2 RAEB-t in CR at reporting |
| Parker (2002)34 23 patients | RA (6); RAEB (6); RAEB-t (!); MDS-AML (6); t-MDS (4) | 48 years (25–63) | fludarabine 150 mg/m2, busulfan 8 mg/kg, CAMPATH 100 mg, cyclosporine; [7 HLA matched sibling; 16 VUD] | 10 months (4–24) | aGVHD (II–IV) 17% cGVHD 15% | 31% (2 years) | 39% (2 years) | 48% (2 years) | |
| Feinstein (2003)35 18 patients | de novo AML (13); 2oAML (5) | 59 years (36–73) | TBI 2 Gy; OR TBI 2Gy, fludarabine 90 mg/m2; cyclosporine, mycophenolate [HLA-matched siblings] | 766 days (188–1141) (survivors) | aGVHD (II–IV) 44% | 0% (D+100); 17% (1 year) | 42% (1 year) | 54% (1 year) | 2 rejections in TBI-only group |
| Author (Study) # Patients . | Disease . | Median Age . | Conditioning & Stem Cell Source . | Median Follow-Up . | GVHD . | NRM . | DFS . | OS . | Comments . |
|---|---|---|---|---|---|---|---|---|---|
| Abbreviations: aGVHD, acute graft-versus-host disease (grade in parentheses); cGVHD, chronic GVHD; ecGVHD, extensive cGVHD; ATG, antithymocyte globulin; NRM, nonrelapse mortality; CDA, 2-chloro-deoxyadenosine; DFS, disease-free survival; OS, overall survival, MTX, methotrexate | |||||||||
| * Number of patients in each diagnostic group is in parentheses | |||||||||
| Giralt (1997)31 15 patients | AML (13); MDS (2) | 59 years (27–71) | fludarabine 120 mg/m2, idarubicin 12 mg/m2, cytarabine 8 g/m2 or melphalan 140 mg/m2; OR cda 60mg/m2, cytarabine 5g/m2 [HLA identical related donor, or 1Ag mismatch] | 100 days (34–175) (survivors) | aGVHD (I) 7%; aGVHD (II) 14%; cGVHD 0% | 33% at reporting | — | — | Median survival 78 days (0–175) |
| Slavin (1998)17 26 patients | MDS (1); AML (8) | 34 years (1–61) | fludarabine 180 mg/m2, busulphan 8 mg/kg, ATG 80 mg/kg; cyclosporine [HLA-matched siblings] | 8 months | aGVHD (III–IV) 25% | 15% (8 months) | 80.7% (8 months) | 85% (8 months) | 2 AML died of GVHD |
| Childs (1999)32 15 patients | RAEB-t (2); CMML (1); non-MDS (12) | 50 years (23–68) | fludarabine 125 mg/m2, cyclophosplamide 120 mg/kg, cyclosporine; [HLA-matched siblings] | 200 days (121–409) (survivors) | aGVHD (II–IV) 60%; cGVHD 27% | 14% (at median follow-up) | 40% (at median follow-up) | 53% (at median follow-up) | 1 MDS patient in CR at median follow-up |
| McSweeney (2001)33 45 patients | RAEB-t (1); AML (10) | 56 years (31–72) | TBI 200 cGy; cyclosporine; mycophenolate [HLA-matched siblings] | 417 days (310–759) (survivors) | aGVHD (II–III) 47% | 6.7% (at median follow-up) | 53% (at median follow-up) | 66.7% (at median follow-up) | RAEB-t progressive disease; 4:10 AML in CR |
| Martino (2001)1976 patients | MDS (12) | 53 years (18–66) | fludarabine 150 mg/m2; melphalan 140 mg/m2 or busulphan 10 mg/kg; cyclosporine, short course MTX [HLA-matched siblings] | 287 days for MDS | aGVHD (II–IV) 32% (100day); ecGvHD 43% (1yr) | 1:12 MDS patients at reporting | 6:12 MDSpatients atreporting | 11:12 MDS patients at reporting | |
| Corradini (2002)18 45 patients | AML (5); RAEB-t (6); | 49 years (20–68) | thiotepa 20 mg/kg; cyclophosphamide 60 mg/kg; fludarabine 60 mg/m2; cyclosporine; [HLA-matched siblingsor 1Ag mismatched related] | 385 days (24–820) | aGVHD (II–IV) 47%; aGVHD (III–IV) 13%; | 13% | — | 53% | 3 AML and 2 RAEB-t in CR at reporting |
| Parker (2002)34 23 patients | RA (6); RAEB (6); RAEB-t (!); MDS-AML (6); t-MDS (4) | 48 years (25–63) | fludarabine 150 mg/m2, busulfan 8 mg/kg, CAMPATH 100 mg, cyclosporine; [7 HLA matched sibling; 16 VUD] | 10 months (4–24) | aGVHD (II–IV) 17% cGVHD 15% | 31% (2 years) | 39% (2 years) | 48% (2 years) | |
| Feinstein (2003)35 18 patients | de novo AML (13); 2oAML (5) | 59 years (36–73) | TBI 2 Gy; OR TBI 2Gy, fludarabine 90 mg/m2; cyclosporine, mycophenolate [HLA-matched siblings] | 766 days (188–1141) (survivors) | aGVHD (II–IV) 44% | 0% (D+100); 17% (1 year) | 42% (1 year) | 54% (1 year) | 2 rejections in TBI-only group |