A Prospective Study Comparing the Outcomes and Health-Related Quality of Life in Adult Patients with Myeloid Malignancies Undergoing Allogeneic Transplantation Using Myeloablative or Reduced-Intensity Conditioning

被引:24
作者
Gupta, Vikas [1 ]
Panzarella, Tony [2 ,3 ]
Li, Le [2 ]
Khan, Jabeen [1 ]
Sharma, Ajay [1 ]
Lipton, Jeffrey H. [1 ]
Kuruvilla, John [1 ]
Messner, Hans [1 ]
Alibhai, Shabbir M. H. [4 ]
机构
[1] Univ Toronto, Princess Margaret Hosp, Blood & Marrow Transplant Program, Toronto, ON M5G 2M9, Canada
[2] Princess Margaret Hosp, Dept Biostat, Toronto, ON M4X 1K9, Canada
[3] Univ Toronto, Dalla Lana Sch Publ Hlth, Toronto, ON M5G 2M9, Canada
[4] Univ Hlth Network, Dept Med, Toronto, ON, Canada
关键词
Myeloablative; Reduced intensity; Quality of life; AML; Survival; HEMATOPOIETIC-CELL TRANSPLANTATION; BONE-MARROW-TRANSPLANTATION; ACUTE MYELOGENOUS LEUKEMIA; VERSUS-HOST-DISEASE; MYELODYSPLASTIC-SYNDROME; LONG-TERM; FUNCTIONAL ASSESSMENT; COMPLETE REMISSION; PATIENTS OLDER; THERAPY;
D O I
10.1016/j.bbmt.2011.05.022
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
We compared the outcomes including health-related quality of life (HRQOL) in adult patients undergoing allogeneic transplantation using myeloablative conditioning (MAC) or reduced-intensity conditioning (RIC). This outcome study was a nonrandomized, prospective, observational noninferiority study, and primarily designed to determine whether RIC was as effective as MAC for myeloid malignancies. Comprehensive longitudinal assessment of HRQOL was done at baseline, day 30, day 100, day 180, and day 365 using validated instruments. A total of 115 patients (MAC, 51; RIC, 64) participated in this study. Of these 115 patients, 105 (91%) participated for HRQOL assessments. The main indication for HCTwas acute myeloid leukemia (72%). Except age (median 41 vs 59 years, P < .0001), baseline characteristics were similar in patients undergoing MAC and RIC, respectively. Progression-free survival (PFS) at 1 year was 59% (SE = 7%) and 53% (SE = 6%) for the patients undergoing MAC and RIC, respectively (90% confidence interval [CI] -9% to +21%, P = .53). No significant difference in overall survival (OS), cumulative incidents of acute and chronic graft-versus-host disease (aGVHD, cGVHD), nonrelapse mortality (NRM) or relapse was observed in the 2 cohorts. The trajectory of decline and recovery of HRQOL was similar between the 2 cohorts. We conclude that clinical outcomes and HRQOL in patients with myeloid malignancies undergoing RIC are not inferior to MAC at 1 year. Biol Blood Marrow Transplant 18: 113-124 (2012) Crown Copyright (C) 2012 Published by Elsevier Inc. on behalf of American Society for Blood and Marrow Transplantation. All rights reserved.
引用
收藏
页码:113 / 124
页数:12
相关论文
共 41 条
[1]   THE EUROPEAN-ORGANIZATION-FOR-RESEARCH-AND-TREATMENT-OF-CANCER QLQ-C30 - A QUALITY-OF-LIFE INSTRUMENT FOR USE IN INTERNATIONAL CLINICAL-TRIALS IN ONCOLOGY [J].
AARONSON, NK ;
AHMEDZAI, S ;
BERGMAN, B ;
BULLINGER, M ;
CULL, A ;
DUEZ, NJ ;
FILIBERTI, A ;
FLECHTNER, H ;
FLEISHMAN, SB ;
DEHAES, JCJM ;
KAASA, S ;
KLEE, M ;
OSOBA, D ;
RAZAVI, D ;
ROFE, PB ;
SCHRAUB, S ;
SNEEUW, K ;
SULLIVAN, M ;
TAKEDA, F .
JOURNAL OF THE NATIONAL CANCER INSTITUTE, 1993, 85 (05) :365-376
[2]   Impact of conditioning regimen intensity on outcome of allogeneic hematopoietic cell transplantation for advanced acute myelogenous leukemia and myelodyspiastic syndrome [J].
Alyea, Edwin P. ;
Kim, Haesook T. ;
Ho, Vincent ;
Cutler, Corey ;
DeAngelo, Daniel J. ;
Stone, Richard ;
Ritz, Jerome ;
Antin, Joseph H. ;
Soiffer, Robert J. .
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION, 2006, 12 (10) :1047-1055
[3]   Comparative outcome of nonmyeloablative and myeloablative allogeneic hematopoietic cell transplantation for patients older than 50 years of age [J].
Alyea, EP ;
Kim, HT ;
Ho, V ;
Cutler, C ;
Gribben, J ;
DeAngelo, DJ ;
Lee, SJ ;
Windawi, S ;
Ritz, J ;
Stone, RM ;
Antin, JH ;
Soiffer, RJ .
BLOOD, 2005, 105 (04) :1810-1814
[4]   Health-Related Quality of Life in Patients Undergoing Allogeneic Stem Cell Transplantation After Reduced Intensity Conditioning Versus Myeloablative Conditioning [J].
Andersson, Inger ;
Ahlberg, Karin ;
Stockelberg, Dick ;
Brune, Mats ;
Persson, Lars-Olof .
CANCER NURSING, 2009, 32 (04) :325-334
[5]   Long-term health-related quality of life, growth, and spiritual well-being after hematopoietic stem-cell transplantation [J].
Andrykowski, MAA ;
Bishop, MM ;
Hahn, EA ;
Cella, DF ;
Beaumont, JL ;
Brady, MJ ;
Horowitz, MM ;
Sobocinski, KA ;
Rizzo, JD ;
Wingard, JR .
JOURNAL OF CLINICAL ONCOLOGY, 2005, 23 (03) :599-608
[6]   Comparative outcome of reduced intensity and myeloablative conditioning regimen in HLA identical sibling allogeneic haematopoietic stem cell transplantation for patients older than 50 years of age with acute myeloblastic leukaemia: a retrospective survey from the Acute Leukemia Working Party (ALWP) of the European group for Blood and Marrow Transplantation (EBMT) [J].
Aoudjhane, M ;
Labopin, M ;
Gorin, NC ;
Shimoni, A ;
Ruutu, T ;
Kolb, HJ ;
Frassoni, F ;
Boiron, JM ;
Yin, JL ;
Finke, J ;
Shouten, H ;
Blaise, D ;
Falda, M ;
Fauser, AA ;
Esteve, J ;
Polge, E ;
Slavin, S ;
Niederwieser, D ;
Nagler, A ;
Rocha, V .
LEUKEMIA, 2005, 19 (12) :2304-2312
[7]   REGIMEN-RELATED TOXICITY IN PATIENTS UNDERGOING BONE-MARROW TRANSPLANTATION [J].
BEARMAN, SI ;
APPELBAUM, FR ;
BUCKNER, CD ;
PETERSEN, FB ;
FISHER, LD ;
CLIFT, RA ;
THOMAS, ED .
JOURNAL OF CLINICAL ONCOLOGY, 1988, 6 (10) :1562-1568
[8]   Health-related quality of life in patients receiving reduced-intensity conditioning allogeneic hematopoietic stem cell transplantation [J].
Bevans, M. F. ;
Marden, S. ;
Leidy, N. K. ;
Soeken, K. ;
Cusack, G. ;
Rivera, P. ;
Mayberry, H. ;
Bishop, M. R. ;
Childs, R. ;
Barrett, A. J. .
BONE MARROW TRANSPLANTATION, 2006, 38 (02) :101-109
[9]   Predictors of response to reinduction chemotherapy for patients with acute myeloid leukemia who do not achieve complete remission with frontline induction chemotherapy [J].
Brandwein, Joseph M. ;
Gupta, Vikas ;
Schuh, Andre C. ;
Schimmer, Aaron D. ;
Yee, Karen ;
Xu, Wei ;
Messner, Hans A. ;
Lipton, Jeffrey H. ;
Minden, Mark D. .
AMERICAN JOURNAL OF HEMATOLOGY, 2008, 83 (01) :54-58
[10]  
Cella D, 1997, SEMIN HEMATOL, V34, P13