Impact of conditioning regimen intensity on outcomes of second allogeneic hematopoietic cell transplantation for secondary acute myelogenous leukemia
Standard
Impact of conditioning regimen intensity on outcomes of second allogeneic hematopoietic cell transplantation for secondary acute myelogenous leukemia. / Nagler, Arnon; Peczynski, Christophe; Dholaria, Bhagirathbhai; Labopin, Myriam; Valerius, Thomas; Dreger, Peter; Kröger, Nicolaus; Reinhardt, Hans Christian; Finke, Jürgen; Franke, Georg-Nikolaus; Ciceri, Fabio; Verbeek, Mareike; Blau, Igor Wolfgang; Bornhäuser, Martin; Spyridonidis, Alexandros; Bug, Gesine; Bazarbachi, Ali; Schmid, Christophe; Yakoub-Agha, Ibrahim; Savani, Bipin N; Mohty, Mohamad.
in: BONE MARROW TRANSPL, Jahrgang 57, Nr. 7, 07.2022, S. 1116-1123.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Impact of conditioning regimen intensity on outcomes of second allogeneic hematopoietic cell transplantation for secondary acute myelogenous leukemia
AU - Nagler, Arnon
AU - Peczynski, Christophe
AU - Dholaria, Bhagirathbhai
AU - Labopin, Myriam
AU - Valerius, Thomas
AU - Dreger, Peter
AU - Kröger, Nicolaus
AU - Reinhardt, Hans Christian
AU - Finke, Jürgen
AU - Franke, Georg-Nikolaus
AU - Ciceri, Fabio
AU - Verbeek, Mareike
AU - Blau, Igor Wolfgang
AU - Bornhäuser, Martin
AU - Spyridonidis, Alexandros
AU - Bug, Gesine
AU - Bazarbachi, Ali
AU - Schmid, Christophe
AU - Yakoub-Agha, Ibrahim
AU - Savani, Bipin N
AU - Mohty, Mohamad
N1 - © 2022. The Author(s), under exclusive licence to Springer Nature Limited.
PY - 2022/7
Y1 - 2022/7
N2 - Limited data is available on factors impacting the outcomes of second hematopoietic cell transplantation (HCT2) in patients with secondary acute myeloid leukemia (sAML). This study aimed to assess HCT2 outcome for sAML comparing reduced-intensity (RIC) to myeloablative (MAC) conditioning. Two hundred and fifteen patients were included: RIC (n = 134), MAC (n = 81). The median follow-up was 41.1 (95% CI: 26.7-69.3) and 28.5 (95% CI: 23.9-75.4) months, respectively. At two years, the relapse incidence (RI) was 58.3% versus 51.1% in RIC and MAC, respectively. The 2-year leukemia free survival (LFS) was 26.6% versus 26%, and the graft-versus-host disease (GVHD)-free, relapse-free survival (GRFS) was 16.4% versus 12.1%, while OS was 31.4% and 39.7%, for RIC and MAC respectively. MVA showed a significantly lower RI [hazard ratio (HR) = 0.46 (95% CI, 0.26-0.8, p = 0.006)] and improved LFS [HR = 0.62 (95% CI, 0.39-0.98, p = 0.042)] with MAC versus RIC. The choice of conditioning regimen did not impact non-relapse mortality [HR = 1.14 (95% CI, 0.52-2.5, p = 0.74)], overall survival (OS) [HR = 0.72 (95% CI, 0.44-1.17, p = 0.18)] or GRFS [HR = 0.89 (95% CI, 0.59-1.36, p = 0.6)]. In conclusion, MAC was associated with a lower RI and superior LFS. These results support the use of MAC for eligible patients with sAML who are being considered for HCT2.
AB - Limited data is available on factors impacting the outcomes of second hematopoietic cell transplantation (HCT2) in patients with secondary acute myeloid leukemia (sAML). This study aimed to assess HCT2 outcome for sAML comparing reduced-intensity (RIC) to myeloablative (MAC) conditioning. Two hundred and fifteen patients were included: RIC (n = 134), MAC (n = 81). The median follow-up was 41.1 (95% CI: 26.7-69.3) and 28.5 (95% CI: 23.9-75.4) months, respectively. At two years, the relapse incidence (RI) was 58.3% versus 51.1% in RIC and MAC, respectively. The 2-year leukemia free survival (LFS) was 26.6% versus 26%, and the graft-versus-host disease (GVHD)-free, relapse-free survival (GRFS) was 16.4% versus 12.1%, while OS was 31.4% and 39.7%, for RIC and MAC respectively. MVA showed a significantly lower RI [hazard ratio (HR) = 0.46 (95% CI, 0.26-0.8, p = 0.006)] and improved LFS [HR = 0.62 (95% CI, 0.39-0.98, p = 0.042)] with MAC versus RIC. The choice of conditioning regimen did not impact non-relapse mortality [HR = 1.14 (95% CI, 0.52-2.5, p = 0.74)], overall survival (OS) [HR = 0.72 (95% CI, 0.44-1.17, p = 0.18)] or GRFS [HR = 0.89 (95% CI, 0.59-1.36, p = 0.6)]. In conclusion, MAC was associated with a lower RI and superior LFS. These results support the use of MAC for eligible patients with sAML who are being considered for HCT2.
KW - Graft vs Host Disease/etiology
KW - Hematopoietic Stem Cell Transplantation/methods
KW - Humans
KW - Leukemia, Myeloid, Acute
KW - Neoplasms, Second Primary
KW - Recurrence
KW - Retrospective Studies
KW - Transplantation Conditioning/methods
U2 - 10.1038/s41409-022-01693-8
DO - 10.1038/s41409-022-01693-8
M3 - SCORING: Journal article
C2 - 35501565
VL - 57
SP - 1116
EP - 1123
JO - BONE MARROW TRANSPL
JF - BONE MARROW TRANSPL
SN - 0268-3369
IS - 7
ER -