Abstract
Patients with acute myeloid leukemia (AML) who relapse after autologous stem cell transplantation (ASCT) can be rescued by allogeneic SCT. We identified 537 adult patients with AML allografted in second complete remission (CR2) or first relapse after ASCT in the European Society for Blood and Marrow Transplantation (EBMT) registry. At 3 years post allograft, leukemia free survival (LFS) was 31.4% [95%CI 27.3-35.6], overall survival (OS) 39.5% [95%CI 35.1-43.9], relapse incidence (RI) 34.6% [95%CI 30.4-38.8], and nonrelapse mortality (NRM) 33.7% [95%CI 29.6-37.9]. RI was higher in patients transplanted in relapse in comparison to those transplanted in CR2 (HR 1.76, P =.004) and in patients who relapsed later after ASCT (HR 0.97 per month, P < 10−3), both translating into better LFS/ OS. Relapse was also lower in patients undergoing allogeneic stem cell transplantation (allo-HSCT) from an unrelated donor (UD) in comparison to those transplanted from a matched sibling donor (MSD) (HR 0.49, P < 10−3). NRM was increased in patients who received total body irradiation (TBI) pre-ASCT (HR 2.43; P < 10-4), translating into worse LFS/OS. LFS/OS did not differ between patients allotransplanted with reduced intensity (RIC) or myeloablative (MAC) conditioning. In conclusion, one third of adult patients with AML relapsing post ASCT can be rescued with allo-HSCT, with better LFS/OS in patients who relapsed later post ASCT, those transplanted in CR2 and those who had not received TBI pre-ASCT.
| Original language | English |
|---|---|
| Pages (from-to) | 1532-1542 |
| Number of pages | 11 |
| Journal | American Journal of Hematology |
| Volume | 93 |
| Issue number | 12 |
| DOIs | |
| Publication status | Published - Dec 1 2018 |
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ASJC Scopus subject areas
- Hematology
Cite this
Allogeneic stem cell transplantation following relapse post autologous stem cell transplantation in adult patients with acute myeloid leukemia : A retrospective analysis of 537 patients from the Acute Leukemia Working Party of the EBMT. / Christopeit, Maximilian; Labopin, Myriam; Gorin, Norbert Claude; Saraceni, Francesco; Passweg, Jakob; Forcade, Edouard; Maertens, Johan; Van Lint, Maria Teresa; Bosi, Alberto; Niederwieser, Dietger; Ehninger, Gerhard; Polge, Emmanuelle; Mohty, Mohamad; Nagler, Arnon.
In: American Journal of Hematology, Vol. 93, No. 12, 01.12.2018, p. 1532-1542.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Allogeneic stem cell transplantation following relapse post autologous stem cell transplantation in adult patients with acute myeloid leukemia
T2 - A retrospective analysis of 537 patients from the Acute Leukemia Working Party of the EBMT
AU - Christopeit, Maximilian
AU - Labopin, Myriam
AU - Gorin, Norbert Claude
AU - Saraceni, Francesco
AU - Passweg, Jakob
AU - Forcade, Edouard
AU - Maertens, Johan
AU - Van Lint, Maria Teresa
AU - Bosi, Alberto
AU - Niederwieser, Dietger
AU - Ehninger, Gerhard
AU - Polge, Emmanuelle
AU - Mohty, Mohamad
AU - Nagler, Arnon
PY - 2018/12/1
Y1 - 2018/12/1
N2 - Patients with acute myeloid leukemia (AML) who relapse after autologous stem cell transplantation (ASCT) can be rescued by allogeneic SCT. We identified 537 adult patients with AML allografted in second complete remission (CR2) or first relapse after ASCT in the European Society for Blood and Marrow Transplantation (EBMT) registry. At 3 years post allograft, leukemia free survival (LFS) was 31.4% [95%CI 27.3-35.6], overall survival (OS) 39.5% [95%CI 35.1-43.9], relapse incidence (RI) 34.6% [95%CI 30.4-38.8], and nonrelapse mortality (NRM) 33.7% [95%CI 29.6-37.9]. RI was higher in patients transplanted in relapse in comparison to those transplanted in CR2 (HR 1.76, P =.004) and in patients who relapsed later after ASCT (HR 0.97 per month, P < 10−3), both translating into better LFS/ OS. Relapse was also lower in patients undergoing allogeneic stem cell transplantation (allo-HSCT) from an unrelated donor (UD) in comparison to those transplanted from a matched sibling donor (MSD) (HR 0.49, P < 10−3). NRM was increased in patients who received total body irradiation (TBI) pre-ASCT (HR 2.43; P < 10-4), translating into worse LFS/OS. LFS/OS did not differ between patients allotransplanted with reduced intensity (RIC) or myeloablative (MAC) conditioning. In conclusion, one third of adult patients with AML relapsing post ASCT can be rescued with allo-HSCT, with better LFS/OS in patients who relapsed later post ASCT, those transplanted in CR2 and those who had not received TBI pre-ASCT.
AB - Patients with acute myeloid leukemia (AML) who relapse after autologous stem cell transplantation (ASCT) can be rescued by allogeneic SCT. We identified 537 adult patients with AML allografted in second complete remission (CR2) or first relapse after ASCT in the European Society for Blood and Marrow Transplantation (EBMT) registry. At 3 years post allograft, leukemia free survival (LFS) was 31.4% [95%CI 27.3-35.6], overall survival (OS) 39.5% [95%CI 35.1-43.9], relapse incidence (RI) 34.6% [95%CI 30.4-38.8], and nonrelapse mortality (NRM) 33.7% [95%CI 29.6-37.9]. RI was higher in patients transplanted in relapse in comparison to those transplanted in CR2 (HR 1.76, P =.004) and in patients who relapsed later after ASCT (HR 0.97 per month, P < 10−3), both translating into better LFS/ OS. Relapse was also lower in patients undergoing allogeneic stem cell transplantation (allo-HSCT) from an unrelated donor (UD) in comparison to those transplanted from a matched sibling donor (MSD) (HR 0.49, P < 10−3). NRM was increased in patients who received total body irradiation (TBI) pre-ASCT (HR 2.43; P < 10-4), translating into worse LFS/OS. LFS/OS did not differ between patients allotransplanted with reduced intensity (RIC) or myeloablative (MAC) conditioning. In conclusion, one third of adult patients with AML relapsing post ASCT can be rescued with allo-HSCT, with better LFS/OS in patients who relapsed later post ASCT, those transplanted in CR2 and those who had not received TBI pre-ASCT.
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UR - http://www.scopus.com/inward/citedby.url?scp=85055530411&partnerID=8YFLogxK
U2 - 10.1002/ajh.25285
DO - 10.1002/ajh.25285
M3 - Article
C2 - 30218444
AN - SCOPUS:85055530411
VL - 93
SP - 1532
EP - 1542
JO - American Journal of Hematology
JF - American Journal of Hematology
SN - 0361-8609
IS - 12
ER -