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Chemotalk Newsletter, Vol. 110: June 1, 2017

Much is new this month, and even more will be forthcoming next month, with the oncology conventions in progress.  As I've said before, skip over what you don't understand because there's plenty you will.  So here goes:

SURVIVALIN MDS EQUIVALENT WITH REDUCED-INTENSITY CONDITIONING

By Leah Lawrence

    Patients with MYELODYSPLASTIC SYNDROME (MDS) undergoing a reduced­intensity conditioning (RIC) regimen prior to allogeneic stem-cell transplantation had similar 2-year relapse-free and overall survival as patients who underwent myeloablative conditioning (MAC), according to the results of the RICMAC trial.

    "The role of conditioning regimen intensity before allogeneic stem-cell transplantation for MDS has not been studied prospectively and recommendations are based on retrospective single-center or registry studies," wrote Nicolaus Kröger, MD, department of stem cell transplantation, University Medical Center Hamburg-Eppendorf, and colleagues in a study published in the Journal of Clinical Oncology. "The rationale for using RIC before allogeneic stem-cell transplantation is to shift from high-dose chemotherapy that is aimed at maximizing cytotoxic leukemia killing to a more immune-mediated effect by harvesting the graft-vs-tumor effect to eradicate the disease."

    In this study, the researchers enrolled 129 patients with MDS or secondary acute myeloid leukemia and randomly assigned them 1:1 to a busulfan-based RIC or MAC.

    At 1 year, the non-relapse mortality was 17% in patients assigned RIC compared with 25% in patients assigned MAC (P = .29). The cumulative incidence of relapse at 2 years was 17% for RIC and 14.8% for MAC. This resulted in a 2-year relapse-free survival of 62.4% for RIC and 58.3% for MAC.

Read more...

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