No improvement of survival with reduced- versus high-intensity conditioning for allogeneic stem cell transplants in Ewing tumor patients
2011; Elsevier BV; Volume: 22; Issue: 7 Linguagem: Inglês
10.1093/annonc/mdq703
ISSN1569-8041
AutoresUwe Thiel, Angela Wawer, Petra Wolf, Manuela Badoglio, Annalisa Santucci, Thomas Klingebiel, Oliver Basu, Arndt Borkhardt, H.-J. Laws, Y Kodera, Ayami Yoshimi, Christina Peters, Ruth Ladenstein, Andrea Pession, Arcangelo Prete, Ernst-Christian Urban, Wolfgang Schwinger, Pierre Bordigoni, Alexandra Salmon, Miguel Ángel Díaz, Boris V. Afanasyev, Igor Lisukov, Еlena V. Morozova, Amos Toren, Bella Bielorai, J. Korsakas, Franca Fagioli, Desirée Caselli, Gerhard Ehninger, Bernd Gruhn, Uta Dirksen, Fawzi Abdel-Rahman, Massimo Aglietta, E. Mastrodicasa, Montserrat Torrent, Paolo Corradini, F Deméocq, Giorgio Dini, Peter Dreger, Matthias Eyrich, Jolanta Goździk, François Guilhot, Ernst Holler, Ewa Kościelniak, Chiara Messina, David Nachbaur, Roberto Sabbatini, Elena Oldani, Hellmut Ottinger, Hülya Özşahin, Rik Schots, Salvatore Siena, Joseph Allen Stein, Sabina Sufliarska, Ali Ünal, Marek Ussowicz, Pascale Schneider, Wilhelm Woessmann, H. Jürgens, Marco Bregni, Stefan Burdach,
Tópico(s)Sarcoma Diagnosis and Treatment
ResumoBackgroundOutcomes of Ewing tumor (ET) patients treated with allogeneic stem cell transplantation (allo-SCT) were compared regarding the use of reduced-intensity conditioning (RIC) and high-intensity conditioning (HIC) regimens as well as human leukocyte antigen (HLA)-matched and HLA-mismatched grafts.Patients and methodsWe retrospectively analyzed data of 87 ET patients from the European Group for Blood and Marrow Transplantation, Pediatric Registry for Stem Cell Transplantations, Asia Pacific Blood and Marrow Transplantation and MetaEICESS registries treated with allo-SCT. Fifty patients received RIC (group A) and 37 patients received HIC (group B). Twenty-four patients received HLA-mismatched grafts and 63 received HLA-matched grafts.ResultsMedian overall survival was 7.9 months [±1.24, 95% confidence interval (CI) 5.44–10.31] for group A and 4.4 months (±1.06, 95% CI 2.29–6.43) for group B patients (P = 1.3). Death of complications (DOC) occurred in 4 of 50 (0.08) and death of disease (DOD) in 33 of 50 (0.66) group A and in 16 of 37 (0.43) and 17 of 37 (0.46) group B patients, respectively. DOC incidence was decreased (P < 0.01) and DOD/relapse increased (P < 0.01) in group A compared with group B. HLA mismatch was not generally associated with graft-versus-Ewing tumor effect (GvETE).ConclusionsThere was no improvement of survival with RIC compared with HIC due to increased DOD/relapse incidence after RIC despite less DOC incidence. This implicates general absence of a clinically relevant GvETE with current protocols.
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