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

E. Todisco, F. Ciceri, C. Boschini, F. Giglio, A. Bacigalupo, F. Patriarca, I. Donnini, E. P. Alessandrino, W. Arcese, A. P. Iori, P. Marenco, I. Cavattoni, P. Chiusolo, E. Terruzzi, L. Castagna, A. Santoro, A. Bosi, E. Oldani, B. Bruno, F. BonifaziA. 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).
Original languageEnglish
Pages (from-to)955-961
Number of pages7
JournalBone Marrow Transplantation
Volume52
Issue number7
DOIs
Publication statusPublished - Jul 1 2017

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Acute Myeloid Leukemia
Transplants
Hematopoietic Stem Cell Transplantation
Confidence Intervals
Survival
Unrelated Donors
Fetal Blood
Cytogenetics
Siblings
Multivariate Analysis
Transplantation
Bone Marrow
Drug Therapy

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Factors predicting outcome after allogeneic transplant in refractory acute myeloid leukemia: a retrospective analysis of Gruppo Italiano Trapianto di Midollo Osseo (GITMO). / Todisco, E.; Ciceri, F.; Boschini, C.; Giglio, F.; Bacigalupo, A.; Patriarca, F.; Donnini, I.; Alessandrino, E. P.; Arcese, W.; Iori, A. P.; Marenco, P.; Cavattoni, I.; Chiusolo, P.; Terruzzi, E.; Castagna, L.; Santoro, A.; Bosi, A.; Oldani, E.; Bruno, B.; Bonifazi, F.; Rambaldi, A.

In: Bone Marrow Transplantation, Vol. 52, No. 7, 01.07.2017, p. 955-961.

Research output: Contribution to journalArticle

Todisco, E, Ciceri, F, Boschini, C, Giglio, F, Bacigalupo, A, Patriarca, F, Donnini, I, Alessandrino, EP, Arcese, W, Iori, AP, Marenco, P, Cavattoni, I, Chiusolo, P, Terruzzi, E, Castagna, L, Santoro, A, Bosi, A, Oldani, E, Bruno, B, Bonifazi, F & Rambaldi, A 2017, 'Factors predicting outcome after allogeneic transplant in refractory acute myeloid leukemia: a retrospective analysis of Gruppo Italiano Trapianto di Midollo Osseo (GITMO)', Bone Marrow Transplantation, vol. 52, no. 7, pp. 955-961. https://doi.org/10.1038/bmt.2016.325 [doi]
Todisco, E. ; Ciceri, F. ; Boschini, C. ; Giglio, F. ; Bacigalupo, A. ; Patriarca, F. ; Donnini, I. ; Alessandrino, E. P. ; Arcese, W. ; Iori, A. P. ; Marenco, P. ; Cavattoni, I. ; Chiusolo, P. ; Terruzzi, E. ; Castagna, L. ; Santoro, A. ; Bosi, A. ; Oldani, E. ; Bruno, B. ; Bonifazi, F. ; Rambaldi, A. / Factors predicting outcome after allogeneic transplant in refractory acute myeloid leukemia: a retrospective analysis of Gruppo Italiano Trapianto di Midollo Osseo (GITMO). In: Bone Marrow Transplantation. 2017 ; Vol. 52, No. 7. pp. 955-961.
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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).",
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T1 - Factors predicting outcome after allogeneic transplant in refractory acute myeloid leukemia: a retrospective analysis of Gruppo Italiano Trapianto di Midollo Osseo (GITMO)

AU - Todisco, E.

AU - Ciceri, F.

AU - Boschini, C.

AU - Giglio, F.

AU - Bacigalupo, A.

AU - Patriarca, F.

AU - Donnini, I.

AU - Alessandrino, E. P.

AU - Arcese, W.

AU - Iori, A. P.

AU - Marenco, P.

AU - Cavattoni, I.

AU - Chiusolo, P.

AU - Terruzzi, E.

AU - Castagna, L.

AU - Santoro, A.

AU - Bosi, A.

AU - Oldani, E.

AU - Bruno, B.

AU - Bonifazi, F.

AU - Rambaldi, A.

N1 - LR: 20171211; JID: 8702459; CIN: Bone Marrow Transplant. 2017 Jul;52(7):950-951. PMID: 28436972; 2016/01/21 00:00 [received]; 2016/09/27 00:00 [revised]; 2016/09/30 00:00 [accepted]; 2017/01/10 06:00 [pubmed]; 2017/01/10 06:00 [medline]; 2017/01/10 06:00 [entrez]; ppublish

PY - 2017/7/1

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N2 - 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).

AB - 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).

U2 - 10.1038/bmt.2016.325 [doi]

DO - 10.1038/bmt.2016.325 [doi]

M3 - Article

VL - 52

SP - 955

EP - 961

JO - Bone Marrow Transplantation

JF - Bone Marrow Transplantation

SN - 0268-3369

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ER -