Longitudinal Outcome over Two Decades of Unrelated Allogeneic Stem Cell Transplantation for Relapsed/Refractory Acute Myeloid Leukemia: An ALWP/EBMT Analysis
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Longitudinal Outcome over Two Decades of Unrelated Allogeneic Stem Cell Transplantation for Relapsed/Refractory Acute Myeloid Leukemia: An ALWP/EBMT Analysis. / Nagler, Arnon; Ngoya, Maud; Galimard, Jacques-Emmanuel; Labopin, Myriam; Bornhäuser, Martin; Stelljes, Matthias; Finke, Jürgen; Ganser, Arnold; Einsele, Herman; Kröger, Nicolaus; Brecht, Arne; Bethge, Wolfgang; Edinger, Matthias; Kulagin, Aleksandr; Passweg, Jakob; Blau, Igor Wolfgang; Elmaagacli, Ahmet; Schäfer-Eckart, Kerstin; Platzbecker, Uwe; Schroeder, Thomas; Bunjes, Donald; Tischer, Johanna; Martin, Sonja; Spyridonidis, Alexandros; Giebel, Sebastian; Savani, Bipin; Mohty, Mohamad.
in: CLIN CANCER RES, Jahrgang 28, Nr. 19, 03.10.2022, S. 4258-4266.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Longitudinal Outcome over Two Decades of Unrelated Allogeneic Stem Cell Transplantation for Relapsed/Refractory Acute Myeloid Leukemia: An ALWP/EBMT Analysis
AU - Nagler, Arnon
AU - Ngoya, Maud
AU - Galimard, Jacques-Emmanuel
AU - Labopin, Myriam
AU - Bornhäuser, Martin
AU - Stelljes, Matthias
AU - Finke, Jürgen
AU - Ganser, Arnold
AU - Einsele, Herman
AU - Kröger, Nicolaus
AU - Brecht, Arne
AU - Bethge, Wolfgang
AU - Edinger, Matthias
AU - Kulagin, Aleksandr
AU - Passweg, Jakob
AU - Blau, Igor Wolfgang
AU - Elmaagacli, Ahmet
AU - Schäfer-Eckart, Kerstin
AU - Platzbecker, Uwe
AU - Schroeder, Thomas
AU - Bunjes, Donald
AU - Tischer, Johanna
AU - Martin, Sonja
AU - Spyridonidis, Alexandros
AU - Giebel, Sebastian
AU - Savani, Bipin
AU - Mohty, Mohamad
N1 - ©2022 American Association for Cancer Research.
PY - 2022/10/3
Y1 - 2022/10/3
N2 - PURPOSE: We evaluated outcomes of unrelated transplantation for primary refractory/relapsed (ref/rel) acute myeloid leukemia (AML), comparing two cohorts according to the year of transplant, 2000-2009 and 2010-2019.PATIENTS AND METHODS: Multivariable analyses were performed using the Cox proportional-hazards regression model.RESULTS: 3,430 patients were included; 876 underwent a transplant between 2000-2009 and 2554 in 2010-2019. Median follow-up was 8.7 (95% CI, 7.8-9.4) and 3.4 (95% CI, 3.1-3.6) years (P < 0.001). Median age was 52 (18-77) and 56 (18-79) years (P > 0.0001); 45.5% and 55.5% had refractory AML while 54.5% and 44.5% had relapsed AML. Conditioning was myeloablative in 60% and 52%, respectively. Neutrophil recovery and day 100 incidence of acute and 2-year incidence of chronic graft-versus-host disease (GvHD) were similar between the two periods. Two-year relapse incidence was higher for patients undergoing transplant in the 2000-2009 period versus those undergoing transplant in 2010-2019: 50.2% versus 45.1% (HR, 0.85; 95% CI, 0.74-0.97; P = 0. 002). Leukemia-free survival; overall survival; and GvHD-free, relapse-free survival were lower for the 2000-2009 period: 26% versus 32.1% (HR, 0.87; 95% CI, 0.78-0.97; P = 0.01), 32.1% versus 38.1% (HR, 0.86; 95% CI, 0.77-0.96; P = 0.01), and 21.5% versus 25.3% (HR, 0.89; 95% CI, 0.81-0.99; P = 0.03), respectively. Two-year nonrelapse mortality was not significantly different (23.8% vs. 23.7%; HR, 0.91; 95% CI, 0.76-1.11; P = 0.34).CONCLUSIONS: Outcome of unrelated transplantation for patients with ref/rel AML has improved in the last two decades, rescuing about one third of the patients. See related commentary by Adrianzen-Herrera and Shastri, p. 4167.
AB - PURPOSE: We evaluated outcomes of unrelated transplantation for primary refractory/relapsed (ref/rel) acute myeloid leukemia (AML), comparing two cohorts according to the year of transplant, 2000-2009 and 2010-2019.PATIENTS AND METHODS: Multivariable analyses were performed using the Cox proportional-hazards regression model.RESULTS: 3,430 patients were included; 876 underwent a transplant between 2000-2009 and 2554 in 2010-2019. Median follow-up was 8.7 (95% CI, 7.8-9.4) and 3.4 (95% CI, 3.1-3.6) years (P < 0.001). Median age was 52 (18-77) and 56 (18-79) years (P > 0.0001); 45.5% and 55.5% had refractory AML while 54.5% and 44.5% had relapsed AML. Conditioning was myeloablative in 60% and 52%, respectively. Neutrophil recovery and day 100 incidence of acute and 2-year incidence of chronic graft-versus-host disease (GvHD) were similar between the two periods. Two-year relapse incidence was higher for patients undergoing transplant in the 2000-2009 period versus those undergoing transplant in 2010-2019: 50.2% versus 45.1% (HR, 0.85; 95% CI, 0.74-0.97; P = 0. 002). Leukemia-free survival; overall survival; and GvHD-free, relapse-free survival were lower for the 2000-2009 period: 26% versus 32.1% (HR, 0.87; 95% CI, 0.78-0.97; P = 0.01), 32.1% versus 38.1% (HR, 0.86; 95% CI, 0.77-0.96; P = 0.01), and 21.5% versus 25.3% (HR, 0.89; 95% CI, 0.81-0.99; P = 0.03), respectively. Two-year nonrelapse mortality was not significantly different (23.8% vs. 23.7%; HR, 0.91; 95% CI, 0.76-1.11; P = 0.34).CONCLUSIONS: Outcome of unrelated transplantation for patients with ref/rel AML has improved in the last two decades, rescuing about one third of the patients. See related commentary by Adrianzen-Herrera and Shastri, p. 4167.
KW - Graft vs Host Disease/epidemiology
KW - Hematopoietic Stem Cell Transplantation/adverse effects
KW - Humans
KW - Leukemia, Myeloid, Acute/complications
KW - Middle Aged
KW - Recurrence
KW - Retrospective Studies
KW - Stem Cell Transplantation
KW - Transplantation Conditioning
U2 - 10.1158/1078-0432.CCR-22-0809
DO - 10.1158/1078-0432.CCR-22-0809
M3 - SCORING: Journal article
C2 - 35670780
VL - 28
SP - 4258
EP - 4266
JO - CLIN CANCER RES
JF - CLIN CANCER RES
SN - 1078-0432
IS - 19
ER -
