Low Non-Relapse mortality and Long-Term preserved quality of life in older patients undergoing matched related donor allogeneic stem cell transplantation

A prospective multicenter phase ii trial

Didier Blaise, Raynier Devillier, Anne Gaëlle Lecoroller-Sorriano, Jean Marie Boher, Agnès Boyer-Chammard, Reza Tabrizi, Patrice Chevallier, Nathalie Fegueux, Anne Sirvent, Mauricette Michallet, Jacques Olivier Bay, Sabine Fürst, Jean El-Cheikh, Laure Vincent, Thierry Guillaume, Caroline Regny, Noël Milpied, Luca Castagna, Mohamad Mohty

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Allogeneic transplantation is a challenge in patients of advanced age because of a high risk of non-relapse mortality and potential long-lasting impairment of health-related quality of life. The development of reduced-intensity conditioning regimens has allowed the use of allogeneic transplantation in this population, but the optimal regimen remains undefined. We conducted a multicenter phase II trial evaluating the safety and efficacy of a reduced-intensity conditioning regimen combining fludarabine, intravenous busulfan, and rabbit antithymocyte globulins in patients older than 55 years of age transplanted from matched-related donor. In addition, health-related quality of life was prospectively measured. Seventy-five patients with a median age of 60 years (range 55-70) were analyzed. Grade III-IV acute and extensive chronic graft-versus-host diseases were found in 3% and 27% of patients, respectively. The day 100 and 1-year non-relapse mortality incidences were 1% and 9%, respectively. The cumulative incidences of relapse, progression-free survival and overall survival at two years were 36%, 51% and 67%, respectively, with a median follow up of 49 months. Global health-related quality of life, physical functioning, emotional functioning, and social functioning were not impaired compared to baseline for more than 75% of the patients (75%, 81.4%, 82.3%, and 75%, respectively). Thirty-four of the 46 (74%) progression-free patients at one year were living without persistent extensive chronic graft-versus-host disease. We conclude that the reduced-intensity conditioning regimen combining fludarabine, intravenous busulfan, and rabbit antithymocyte globulins is well tolerated in patients older than 55 years with low non-relapse mortality and long-term preserved quality of life.

Original languageEnglish
Pages (from-to)269-274
Number of pages6
JournalHaematologica
Volume100
Issue number2
DOIs
Publication statusPublished - 2015

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Stem Cell Transplantation
Quality of Life
Tissue Donors
Mortality
Busulfan
Antilymphocyte Serum
Homologous Transplantation
Graft vs Host Disease
Rabbits
Incidence
Disease-Free Survival
Safety
Recurrence
Survival
Population

ASJC Scopus subject areas

  • Hematology

Cite this

Low Non-Relapse mortality and Long-Term preserved quality of life in older patients undergoing matched related donor allogeneic stem cell transplantation : A prospective multicenter phase ii trial. / Blaise, Didier; Devillier, Raynier; Lecoroller-Sorriano, Anne Gaëlle; Boher, Jean Marie; Boyer-Chammard, Agnès; Tabrizi, Reza; Chevallier, Patrice; Fegueux, Nathalie; Sirvent, Anne; Michallet, Mauricette; Bay, Jacques Olivier; Fürst, Sabine; El-Cheikh, Jean; Vincent, Laure; Guillaume, Thierry; Regny, Caroline; Milpied, Noël; Castagna, Luca; Mohty, Mohamad.

In: Haematologica, Vol. 100, No. 2, 2015, p. 269-274.

Research output: Contribution to journalArticle

Blaise, D, Devillier, R, Lecoroller-Sorriano, AG, Boher, JM, Boyer-Chammard, A, Tabrizi, R, Chevallier, P, Fegueux, N, Sirvent, A, Michallet, M, Bay, JO, Fürst, S, El-Cheikh, J, Vincent, L, Guillaume, T, Regny, C, Milpied, N, Castagna, L & Mohty, M 2015, 'Low Non-Relapse mortality and Long-Term preserved quality of life in older patients undergoing matched related donor allogeneic stem cell transplantation: A prospective multicenter phase ii trial', Haematologica, vol. 100, no. 2, pp. 269-274. https://doi.org/10.3324/haematol.2014.113571
Blaise, Didier ; Devillier, Raynier ; Lecoroller-Sorriano, Anne Gaëlle ; Boher, Jean Marie ; Boyer-Chammard, Agnès ; Tabrizi, Reza ; Chevallier, Patrice ; Fegueux, Nathalie ; Sirvent, Anne ; Michallet, Mauricette ; Bay, Jacques Olivier ; Fürst, Sabine ; El-Cheikh, Jean ; Vincent, Laure ; Guillaume, Thierry ; Regny, Caroline ; Milpied, Noël ; Castagna, Luca ; Mohty, Mohamad. / Low Non-Relapse mortality and Long-Term preserved quality of life in older patients undergoing matched related donor allogeneic stem cell transplantation : A prospective multicenter phase ii trial. In: Haematologica. 2015 ; Vol. 100, No. 2. pp. 269-274.
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