Impact of the Intensity of Conditioning Therapy On the Outcomes of Patients Aged 40 to 60 Years with Acute Myeloid Leukemia/Myelodysplastic Syndrome Undergoing Allogeneic Hematopoietic Cell Transplantation.
Notice bibliographique
Résumé
Abstract Abstract 1202 Poster Board I-224 Introduction: The eligibility of patients to undergo allogeneic hematopoietic cell transplantation (AHCT) is limited by age, co-morbid conditions and performance status. Utilizing reduced and minimal intensity conditioning regimens, older and less fit patients could benefit from this modality with the graft versus leukemia effect. Methods: We performed a retrospective analysis of adults aged 40-60 years with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS) undergoing AHCT at our center from January 2002 to June 2008. The objective of the study is to compare the overall (OS), relapse free (RFS), acute GvHD free and chronic GvHD free survival between the different conditioning regimens. The regimens are classified according to the definition of CIBMTR as conventional intensity (CIC) or reduced intensity (RIC). High risk disease is defined as patients meeting one of the following criteria: AML with poor risk cytogenetics, secondary AML with preceding hematologic disorder, AML in second complete remission or AML/MDS with preceding malignancy. Results: There are 106 patients eligible for the study (CIC 67, RIC 39); 56 patients with de novo AML, 22 with MDS and 28 with secondary AML. High risk disease comprised 64% of our study population. The baseline characteristics between the two groups including performance status (Karnofsky Performance Score; CIC 81%, RIC 83%, p=0.08) are not different except for age (mean in years; CIC 50.2, RIC 52.9, p=0.03), graft versus host disease (GvHD) prophylaxis (cyclosporine/alemtuzumab; CIC 16%, RIC 57%, p<0.001), donor type (unrelated donor; CIC 30%, RIC 54%, p=0.04) and Seattle co-morbidity index score (score of ≥3; CIC 12%, RIC 31%, p=0.03). The median follow up duration for all patients was 1.93 years. There is no statistically significant difference in the OS between the two groups (median OS in years; CIC 1.93, RIC 2.59, Log-rank p=0.62). Furthermore, RFS between the two groups were similar (median RFS was not reached in either groups, Log-rank p=0.86). Using Cox-model adjusting for important prognostic factors at baseline (age, disease risk, donor type, performance status, Co-morbidity index score and type of conditioning regimen), only performance status and disease risk are significant for both OS (HR 0.906 [p=0.01] and 2.13 [p=0.04] respectively) and RFS (HR 0.854 [p=0.04] and 6.931 [p=0.007] respectively). The acute GvHD and chronic GvHD free survival curves are not significantly different in the two groups (Log-rank p values are 0.66 and 0.16 respectively). Conclusion: Despite inferior baseline characteristics in the patients receiving RIC, the outcomes were similar. Disease biology rather than intensity of the conditioning therapy is the determinant of overall survival and relapse risk after AHCT in patients aged 40-60 years with AML/MDS. Prospective randomized studies are needed to determine the superiority of RIC in patients who are deemed suitable to undergo CIC. Disclosures: No relevant conflicts of interest to declare.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».