Treatment, risk factors, and outcome of adults with relapsed AML after reduced intensity conditioning for allogeneic stem cell transplantation.
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Treatment, risk factors, and outcome of adults with relapsed AML after reduced intensity conditioning for allogeneic stem cell transplantation. / Schmid, Christoph; Labopin, Myriam; Nagler, Arnon; Niederwieser, Dietger; Castagna, Luca; Tabrizi, Reza; Stadler, Michael; Kuball, Jürgen; Cornelissen, Jan; Vorlicek, Jiri; Socié, Gerard; Falda, Michele; Vindeløv, Lars; Ljungman, Per; Jackson, Graham; Kröger, Nicolaus; Rank, Andreas; Polge, Emmanuelle; Rocha, Vanderson; Mohty, Mohamad; Blood, Acute Leukaemia Working Party Of The European Group For; Transplantation, Marrow.
In: BLOOD, Vol. 119, No. 6, 6, 2012, p. 1599-1606.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Treatment, risk factors, and outcome of adults with relapsed AML after reduced intensity conditioning for allogeneic stem cell transplantation.
AU - Schmid, Christoph
AU - Labopin, Myriam
AU - Nagler, Arnon
AU - Niederwieser, Dietger
AU - Castagna, Luca
AU - Tabrizi, Reza
AU - Stadler, Michael
AU - Kuball, Jürgen
AU - Cornelissen, Jan
AU - Vorlicek, Jiri
AU - Socié, Gerard
AU - Falda, Michele
AU - Vindeløv, Lars
AU - Ljungman, Per
AU - Jackson, Graham
AU - Kröger, Nicolaus
AU - Rank, Andreas
AU - Polge, Emmanuelle
AU - Rocha, Vanderson
AU - Mohty, Mohamad
AU - Blood, Acute Leukaemia Working Party Of The European Group For
AU - Transplantation, Marrow
PY - 2012
Y1 - 2012
N2 - 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.
AB - 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.
KW - Adult
KW - Humans
KW - Male
KW - Aged
KW - Female
KW - Middle Aged
KW - Risk Factors
KW - Adolescent
KW - Young Adult
KW - Treatment Outcome
KW - Europe
KW - Prognosis
KW - Retrospective Studies
KW - Recurrence
KW - Remission Induction
KW - Acute Disease
KW - Kaplan-Meier Estimate
KW - Transplantation, Homologous
KW - Hematopoietic Stem Cell Transplantation/methods
KW - Leukemia, Myeloid/pathology/surgery
KW - Registries/statistics & numerical data
KW - Transplantation Conditioning/methods
KW - Adult
KW - Humans
KW - Male
KW - Aged
KW - Female
KW - Middle Aged
KW - Risk Factors
KW - Adolescent
KW - Young Adult
KW - Treatment Outcome
KW - Europe
KW - Prognosis
KW - Retrospective Studies
KW - Recurrence
KW - Remission Induction
KW - Acute Disease
KW - Kaplan-Meier Estimate
KW - Transplantation, Homologous
KW - Hematopoietic Stem Cell Transplantation/methods
KW - Leukemia, Myeloid/pathology/surgery
KW - Registries/statistics & numerical data
KW - Transplantation Conditioning/methods
M3 - SCORING: Journal article
VL - 119
SP - 1599
EP - 1606
JO - BLOOD
JF - BLOOD
SN - 0006-4971
IS - 6
M1 - 6
ER -
