Abstract | PURPOSE: PATIENTS AND METHODS: RESULTS: Overall survival (OS) after transplantation was significantly superior in the sirolimus group, which was confirmed in multivariable analysis. The benefit was restricted to patients undergoing reduced-intensity conditioning (RIC) HSCT (3-year OS, 66% for sirolimus group v 38% for no- sirolimus group; P = .007; hazard ratio [HR] for mortality in multivariable analysis = 0.5, P = .042). Patients who received sirolimus had a similar incidence of nonrelapse mortality but a decreased incidence of disease progression compared with patients who did not receive sirolimus (3-year cumulative incidence of progression, 42% v 74%, respectively; P < .001; HR for progression in multivariable analysis = 0.4, P = .01). The effect of sirolimus persisted after adjusting for the occurrence of GVHD. No such survival advantage was apparent in a similar comparison of patients who underwent transplantation for diseases other than lymphoma. CONCLUSION: This study suggests that sirolimus can independently decrease the risk of lymphoma progression after RIC HSCT, paving the way for prospective clinical trials.
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Authors | Philippe Armand, Supriya Gannamaneni, Haesook T Kim, Corey S Cutler, Vincent T Ho, John Koreth, Edwin P Alyea, Ann S LaCasce, Eric D Jacobsen, David C Fisher, Jennifer R Brown, George P Canellos, Arnold S Freedman, Robert J Soiffer, Joseph H Antin |
Journal | Journal of clinical oncology : official journal of the American Society of Clinical Oncology
(J Clin Oncol)
Vol. 26
Issue 35
Pg. 5767-74
(Dec 10 2008)
ISSN: 1527-7755 [Electronic] United States |
PMID | 19001324
(Publication Type: Comparative Study, Journal Article, Multicenter Study, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
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Chemical References |
- Calcineurin Inhibitors
- Immunosuppressive Agents
- Calcineurin
- Sirolimus
- Methotrexate
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Topics |
- Adult
- Aged
- Boston
- Calcineurin
(metabolism)
- Calcineurin Inhibitors
- Disease-Free Survival
- Graft vs Host Disease
(etiology, mortality, prevention & control)
- Hematopoietic Stem Cell Transplantation
(adverse effects)
- Humans
- Immunosuppressive Agents
(therapeutic use)
- Kaplan-Meier Estimate
- Lymphoma
(mortality, surgery)
- Methotrexate
(therapeutic use)
- Middle Aged
- Retrospective Studies
- Sirolimus
(therapeutic use)
- Time Factors
- Transplantation Conditioning
(adverse effects)
- Transplantation, Homologous
- Treatment Outcome
- Young Adult
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