Allogeneic stem cell transplant in patients with acute myeloid leukemia and karnofsky performance status score less than or equal to 80%: A study from the acute leukemia working party of the European Society for Blood and Marrow Transplantation (EBMT)
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Allogeneic stem cell transplant in patients with acute myeloid leukemia and karnofsky performance status score less than or equal to 80%: A study from the acute leukemia working party of the European Society for Blood and Marrow Transplantation (EBMT). / Saraceni, Francesco; Labopin, Myriam; Forcade, Edouard; Kröger, Nicolaus; Socié, Gerard; Niittyvuopio, Riitta; Cornelissen, Jan J; Labussière-Wallet, Hélène; Blaise, Didier; Choi, Goda; Byrne, Jenny L; Guillerm, Gaelle; Marchand, Tony; Esteve, Jordi; Bazarbachi, Ali; Savani, Bipin; Olivieri, Attilio; Nagler, Arnon; Mohty, Mohamad.
in: CANCER MED-US, Jahrgang 10, Nr. 1, 01.2021, S. 23-33.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - Allogeneic stem cell transplant in patients with acute myeloid leukemia and karnofsky performance status score less than or equal to 80%: A study from the acute leukemia working party of the European Society for Blood and Marrow Transplantation (EBMT)
AU - Saraceni, Francesco
AU - Labopin, Myriam
AU - Forcade, Edouard
AU - Kröger, Nicolaus
AU - Socié, Gerard
AU - Niittyvuopio, Riitta
AU - Cornelissen, Jan J
AU - Labussière-Wallet, Hélène
AU - Blaise, Didier
AU - Choi, Goda
AU - Byrne, Jenny L
AU - Guillerm, Gaelle
AU - Marchand, Tony
AU - Esteve, Jordi
AU - Bazarbachi, Ali
AU - Savani, Bipin
AU - Olivieri, Attilio
AU - Nagler, Arnon
AU - Mohty, Mohamad
N1 - © 2020 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
PY - 2021/1
Y1 - 2021/1
N2 - Limited data are currently available on the outcome of patients with acute myeloid leukemia (AML) undergoing allogeneic stem cell transplantation (allo-SCT) with a reduced performance status. We herein present the results of a registry study on 2,936 AML patients undergoing allo-SCT in first remission (CR1) with a Karnofsky Performance Status (KPS) score less than or equal to 80%. Two-year leukemia-free survival (LFS), overall survival (OS) and graft-versus-host disease (GVHD)-free, and relapse-free survival (GRFS) rates were 54%, 59%, and 41%, respectively. In multivariable analysis, patients with a KPS score = 80% had lower non-relapse mortality (NRM) and superior OS in comparison to patients with a KPS score <80% (p < 0.001). In the subgroup of patients with a KPS score =80%, a reduced-intensity conditioning (RIC) regimen was associated with an increased risk of relapse (p = 0.002) and lower GRFS (p < 0.001) compared to myeloablative conditioning (MAC). Differently, in patients with a KPS score <80%, a RIC regimen resulted in lower NRM (p < 0.001), whereas relapse incidence did not differ, thus leading to an improved GRFS (p = 0.008) as compared to MAC. A transplant from a matched sibling donor (MSD) was associated with a reduced incidence of grade III-IV acute GVHD (p < 0.01) and NRM (p < 0.01) in comparison to other donor types. In conclusion, allo-SCT appears feasible in AML patients with a jeopardized KPS score. Survival is significantly affected by the conditioning intensity, which should be adjusted according to the severity of KPS impairment.
AB - Limited data are currently available on the outcome of patients with acute myeloid leukemia (AML) undergoing allogeneic stem cell transplantation (allo-SCT) with a reduced performance status. We herein present the results of a registry study on 2,936 AML patients undergoing allo-SCT in first remission (CR1) with a Karnofsky Performance Status (KPS) score less than or equal to 80%. Two-year leukemia-free survival (LFS), overall survival (OS) and graft-versus-host disease (GVHD)-free, and relapse-free survival (GRFS) rates were 54%, 59%, and 41%, respectively. In multivariable analysis, patients with a KPS score = 80% had lower non-relapse mortality (NRM) and superior OS in comparison to patients with a KPS score <80% (p < 0.001). In the subgroup of patients with a KPS score =80%, a reduced-intensity conditioning (RIC) regimen was associated with an increased risk of relapse (p = 0.002) and lower GRFS (p < 0.001) compared to myeloablative conditioning (MAC). Differently, in patients with a KPS score <80%, a RIC regimen resulted in lower NRM (p < 0.001), whereas relapse incidence did not differ, thus leading to an improved GRFS (p = 0.008) as compared to MAC. A transplant from a matched sibling donor (MSD) was associated with a reduced incidence of grade III-IV acute GVHD (p < 0.01) and NRM (p < 0.01) in comparison to other donor types. In conclusion, allo-SCT appears feasible in AML patients with a jeopardized KPS score. Survival is significantly affected by the conditioning intensity, which should be adjusted according to the severity of KPS impairment.
U2 - 10.1002/cam4.3593
DO - 10.1002/cam4.3593
M3 - SCORING: Journal article
C2 - 33242374
VL - 10
SP - 23
EP - 33
JO - CANCER MED-US
JF - CANCER MED-US
SN - 2045-7634
IS - 1
ER -
