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@article{1108014,
author = {Pfeiffer, Tim and Schleuning, Michael J. and Mayer, Jiří and Haude, Karl Heinz and Tischer, Johanna and Buchholz, Stefanie and Bunjes, Donald W. and Bug, Gesine and Holler, Ernst and Meyer, Ralf Georg and Greinix, Hildegard T. and Scheid, Christof and Christopeit, Maximilian and Schnittger, Susanne and Braess, Jan and Schlimok, Günter and Spiekermann, Karsten and Ganser, Arnold and Kolb, Hans Jochem and Schmid, Çhristof C.},
article_location = {Pavia},
article_number = {4},
doi = {http://dx.doi.org/10.3324/haematol.2012.070235},
keywords = {acute granulocytic leukemia; adult; aged; allogeneic stem cell transplantation;},
language = {eng},
issn = {0390-6078},
journal = {Haematologica/the hematology journal},
title = {Influence of molecular subgroups on outcome of acute myeloid leukemia with normal karyotype in 141 patients undergoing salvage allogeneic stem cell transplantation in primary induction failure or beyond first relapse},
volume = {Vol. 98},
year = {2013}
}
TY - JOUR
ID - 1108014
AU - Pfeiffer, Tim - Schleuning, Michael J. - Mayer, Jiří - Haude, Karl Heinz - Tischer, Johanna - Buchholz, Stefanie - Bunjes, Donald W. - Bug, Gesine - Holler, Ernst - Meyer, Ralf Georg - Greinix, Hildegard T. - Scheid, Christof - Christopeit, Maximilian - Schnittger, Susanne - Braess, Jan - Schlimok, Günter - Spiekermann, Karsten - Ganser, Arnold - Kolb, Hans Jochem - Schmid, Çhristof C.
PY - 2013
TI - Influence of molecular subgroups on outcome of acute myeloid leukemia with normal karyotype in 141 patients undergoing salvage allogeneic stem cell transplantation in primary induction failure or beyond first relapse
JF - Haematologica/the hematology journal
VL - Vol. 98
IS - 4
SP - 518-525
EP - 518-525
PB - Ferrata Storti Foundation
SN - 03906078
KW - acute granulocytic leukemia
KW - adult
KW - aged
KW - allogeneic stem cell transplantation;
N2 - Based on molecular aberrations, in particular the NPM1 mutation (NPM1mut) and the FLT3 internal tandem duplication (Flt3-ITD), prognostic subgroups have been defined among patients with acute myeloid leukemia with normal karyotype. Whereas these subgroups are known to play an important role in outcome in first complete remission, and also in the indication for allogeneic stem cell transplantation, data are limited on their role after transplantation in advanced disease. To evaluate the role of molecular subgroups of acute myeloid leukemia with normal karyotype after allogeneic stem cell transplantation beyond first complete remission, we analyzed the data from 141 consecutive adults (median age: 51.0 years, range 18.4-69.3 years) who had received an allogeneic transplant either in primary induction failure or beyond first complete remission. A sequential regimen of cytoreductive chemotherapy (fludarabine, high-dose AraC, amsacrine) followed by reduced intensity conditioning (FLAMSA-RIC), was uniformly used for conditioning. After a median follow up of three years, overall survival from transplantation was 64+/-4%, 53+/-4% and 44+/-5% at one, two and four years, respectively. Forty patients transplanted in primary induction failure achieved an encouraging 2-year survival of 69%. Among 101 patients transplanted beyond first complete remission, 2-year survival was 81% among patients with the NPM1mut/FLT3wt genotype in contrast to 43% in other genotypes. Higher numbers of transfused CD34+ cells (hazard ratio 2.155, 95% confidence interval 0.263-0.964, P=0.039) and favorable genotype (hazard ratio 0.142, 95% confidence interval: 0.19-0.898, P=0.048) were associated with superior overall survival in multivariate analysis. In conclusion, patients with acute myeloid leukemia with normal karyotype can frequently be rescued after primary induction failure by allogeneic transplantation following FLAMSA-RIC. The prognostic role of NPM1mut/FLT3-ITD based subgroups was carried through after allogeneic stem cell transplantation beyond first complete remission.
ER -
PFEIFFER, Tim, Michael J. SCHLEUNING, Jiří MAYER, Karl Heinz HAUDE, Johanna TISCHER, Stefanie BUCHHOLZ, Donald W. BUNJES, Gesine BUG, Ernst HOLLER, Ralf Georg MEYER, Hildegard T. GREINIX, Christof SCHEID, Maximilian CHRISTOPEIT, Susanne SCHNITTGER, Jan BRAESS, Günter SCHLIMOK, Karsten SPIEKERMANN, Arnold GANSER, Hans Jochem KOLB a $\backslash$c Christof C. SCHMID. Influence of molecular subgroups on outcome of acute myeloid leukemia with normal karyotype in 141 patients undergoing salvage allogeneic stem cell transplantation in primary induction failure or beyond first relapse. \textit{Haematologica/the hematology journal}. Pavia: Ferrata Storti Foundation, Vol. 98, č.~4, s.~518-525. ISSN~0390-6078. doi:10.3324/haematol.2012.070235. 2013.
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