Factors predicting outcome after allogeneic transplant in refractory acute myeloid leukemia: a retrospective analysis of Gruppo Italiano Trapianto di Midollo Osseo (GITMO)

Elisabetta Todisco, F. Ciceri, Cristina Boschini, Ada F. Giglio, A. Bacigalupo, F. Patriarca, I. Donnini, E. P. Alessandrino, Giorgio W. Arcese, A. P. Iori, P. Marenco, Irene Cavattoni, Patrizia Chiusolo, Elisabetta Terruzzi, L. Castagna, A. Santoro, A. Bosi, Elena Oldani, B. Bruno, F. BonifaziAlessandro Rambaldi

Research output: Contribution to journalArticle

Abstract

The clinical outcome of primary refractory (PRF) AML patients is poor and only a minor proportion of patients is rescued by allogenic hematopoietic stem cell transplantation (HSCT). The identification of pre-HSCT variables may help to determine PRF AML patients who can most likely benefit from HSCT. We analyzed PRF AML patients transplanted between 1999 and 2012 from a sibling, unrelated donor or a cord blood unit. Overall, 227 patients from 26 Gruppo Italiano Trapianto di Midollo Osseo e Terapia cellulare centers were included in the analysis. At 3 years, the overall survival was 14%. By multivariate analysis, the number of chemotherapy cycles, (hazard ratio (HR): 1.87; 95% confidence interval (CI): 1.24–2.85; P=0.0028), the percentage of bone marrow or peripheral blood blasts (HR: 1.75; 95% CI: 1.16–2.64; P=0.0078), the adverse cytogenetic (HR: 1.44; 95% CI: 1.00–2.07; P=0.0508) and the age of patients (HR: 1.77; 95% CI: 1.08–2.88; P=0.0223) remained significantly associated with survival. Thus, we set up a new score predicting at 3 years after transplantation, an overall survival probability of 32% for patients with score 0 (no or 1 prognostic factor), 10% for patients with score 1 (2 prognostic factors) and 3% for patients with score 2 (3 or 4 prognostic factors).Bone Marrow Transplantation advance online publication, 9 January 2017; doi:10.1038/bmt.2016.325.

Original languageEnglish
JournalBone Marrow Transplantation
DOIs
Publication statusAccepted/In press - Jan 9 2017

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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