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SCT
Hi Alison,
Here is an abstract from specialists in SCT - as you se the 2 year overall survival is 53 % with the reduced-intensity conditioning.
We don´t know much about the outcome for your dad with new drugs. Vidaza can be combined with new effective drugs called histone deacetylase inhibitors like Zolinza. Then you can treat low WBC:s with Neupogen and a new drug for low platelets (Eltrombopag/Promacta) will perhaps be approved this summer.
"Reduced-intensity conditioning for allogeneic hematopoietic stem cell transplantation with fludarabine and melphalan is associated with durable disease control in myelodysplastic syndrome.
Bone Marrow Transplant. 2007 Nov;40(9):843-50.
Nakamura R, Rodriguez R, Palmer J, Stein A, Naing A, Tsai N, Chang K, Slovak ML, Bhatia R, Spielberger R, Kogut N, Pullarkat V, Kirschbaum M, Forman SJ, O'Donnell MR.
Division of Hematology/Hematopoietic Cell Transplantation, City of Hope Comprehensive Cancer Center, Duarte, CA 91010, USA
We retrospectively evaluated the outcome of reduced-intensity conditioning followed by allogeneic hematopoietic stem cell transplantation in 43 patients with MDS or AML arising from MDS. hematopoietic stem cell transplantation
All patients received fludarabine plus melphalan followed by an allogeneic hematopoietic stem cell transplantation from an HLA-identical sibling (n=19) or unrelated donor (n=24). Median age was 58 years (range: 30-71). Diagnoses at transplantation were RA (n=8), RARS (n=1), RAEB (n=13), RAEB-T (n=6), or AML arising from MDS (n=15).
Of 28 patients with MDS, two patients had low, 10 had intermediate-1, nine had intermediate-2 and seven had high-risk MDS by IPSS criteria. All patients initially engrafted with the median neutrophil recovery of 15 days (range: 9-27).
The 2-year overall survival, disease-free survival, relapse and transplant-related mortality were 53.5% (CI 45.2-61.1), 51.2% (CI 43.3-58.5), 16.3% (CI 7.9-30.7) and 35.2% (26.4-45.7), respectively.
Grade II-IV acute graft-versus-host disease occurred in 27 (63%) patients. There was no significant survival difference between sibling and unrelated donor hematopoietic stem cell transplantation, but the relapse rate was higher among sibling donor recipients when compared to unrelated donor (38.5 versus 7%, P=0.02). Reduced-intensity conditioning with fludarabine plus melphalan was associated with durable disease control and acceptable toxicity in this high-risk cohort."
Kind regards
Birgitta-A
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