Treatment, risk factors, and outcome of adults with relapsed AML after reduced intensity conditioning for allogeneic stem cell transplantation

SCHMID, Christoph, Myriam LABOPIN, Arnon NAGLER, Dietger NIEDERWIESER, Luca CASTAGNA, Reza TABRIZI, Michael STADLER, Juergen KUBALL, Jan CORNELISSEN, Jiří VORLÍČEK, Gerard SOCIÉ, Michele FALDA, Lars VINDELOV, Per LJUNGMAN, Graham JACKSON, Nicolaus KROEGER, Andreas RANK, Emmanuelle POLGE, Vanderson ROCHA a Mohamad MOHTY. Treatment, risk factors, and outcome of adults with relapsed AML after reduced intensity conditioning for allogeneic stem cell transplantation. Blood. Washington DC, USA: American Society of Hematology, 2012, roč. 119, č. 6, s. 1599-1606. ISSN 0006-4971. Dostupné z: https://dx.doi.org/10.1182/blood-2011-08-375840.

Základní údaje

• Originální název: Treatment, risk factors, and outcome of adults with relapsed AML after reduced intensity conditioning for allogeneic stem cell transplantation
• Autoři: SCHMID, Christoph, Myriam LABOPIN, Arnon NAGLER, Dietger NIEDERWIESER, Luca CASTAGNA, Reza TABRIZI, Michael STADLER, Juergen KUBALL, Jan CORNELISSEN, Jiří VORLÍČEK, Gerard SOCIÉ, Michele FALDA, Lars VINDELOV, Per LJUNGMAN, Graham JACKSON, Nicolaus KROEGER, Andreas RANK, Emmanuelle POLGE, Vanderson ROCHA a Mohamad MOHTY.
• Vydání: Blood, Washington DC, USA, American Society of Hematology, 2012, 0006-4971.

Další údaje

• Originální jazyk: angličtina
• Typ výsledku: Článek v odborném periodiku
• Obor: 30200 3.2 Clinical medicine
• Stát vydavatele: Spojené státy
• Utajení: není předmětem státního či obchodního tajemství
• Impakt faktor: Impact factor: 9.060
• Organizační jednotka: Lékařská fakulta
• Doi: http://dx.doi.org/10.1182/blood-2011-08-375840
• UT WoS: 000300420900037
• Klíčová slova anglicky: ACUTE MYELOID-LEUKEMIA; BONE-MARROW-TRANSPLANTATION; 1ST INTERNATIONAL WORKSHOP; GRAFT-VERSUS-LEUKEMIA; LOW-DOSE AZACITIDINE; MYELODYSPLASTIC SYNDROMES; HEMATOLOGIC MALIGNANCIES; MYELOABLATIVE THERAPY; PATIENTS OLDER; WORKING PARTY
• Příznaky: Mezinárodní význam, Recenzováno

Anotace

Because information on management and outcome of AML relapse after allogeneic hematopoietic stem cell transplantation (HSCT) with reduced intensity conditioning (RIC) is scarce, a retrospective registry study was performed by the Acute Leukemia Working Party of EBMT. Among 2815 RIC transplants performed for AML in complete remission (CR) between 1999 and 2008, cumulative incidence of relapse was 32% +/- 1%. Relapsed patients (263) were included into a detailed analysis of risk factors for overall survival (OS) and building of a prognostic score. CR was reinduced in 32%; remission duration after transplantation was the only prognostic factor for response (P = .003). Estimated 2-year OS from relapse was 14%, thereby resembling results of AML relapse after standard conditioning. Among variables available at the time of relapse, remission after HSCT > 5 months (hazard ratio [HR] = 0.50, 95% confidence interval [CI], 0.37-0.67, P < .001), bone marrow blasts less than 27% (HR = 0.53, 95% CI, 0.40-0.72, P < .001), and absence of acute GVHD after HSCT (HR = 0.67, 95% CI, 0.49-0.93, P = .017) were associated with better OS. Based on these factors, 3 prognostic groups could be discriminated, showing OS of 32% +/- 7%, 19% +/- 4%, and 4% +/- 2% at 2 years (P < .0001). Long-term survival was achieved almost exclusively after successful induction of CR by cytoreductive therapy, followed either by donor lymphocyte infusion or second HSCT for consolidation.