Improved outcome in young adults with de novo acute myeloid leukemia in first remission, undergoing an allogeneic bone marrow transplant

D. Vicente, T. Lamparelli, F. Gualandi, D. Occhini, A. M. Raiola, A. Ibatici, M. T. Van Lint, M. Gobbi, M. Miglino, M. Clavio, M. Risso, F. Frassoni, A. Bacigalupo

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Abstract

We assessed the outcome of 170 patients with AML in first complete remission, aged 1-47 years (median 29), who had undergone an allogeneic BMT before or after 1990 (n=80 and n=90, respectively); all patients were prepared with cyclophosphamide and TBI; the median follow-up for surviving patients was 13 years. The donor was an HLA-identical sibling in 164 patients. Transplant-related mortality (TRM) was 30% before and 7% after 1990 (P=0.001); relapse-related death (RRD) was 26 and 11% (P=0.002); and actuarial 10-year survival was 42 and 79% (P=0.00001). Patients transplanted after 1990 were older, had a shorter interval diagnosis-BMT, had less FAB-M3 cases, received a higher dose of TBI, a higher marrow cell dose and combined (cyclosporine+methotrexate) GVHD prophylaxis. Patients relapsing after transplant had an actuarial survival of 0 vs 31% if grafted before or after 1990 (P=0.01), and their median follow-up exceeds 10 years. In conclusion, the overall survival of first remission AML undergoing an allogeneic BMT has almost doubled in the past two decades, despite older age and fewer M3 cases. Improvement has come not only from changes in transplant procedures, but also from effective rescue of patients relapsing after transplant.

Original languageEnglish
Pages (from-to)349-354
Number of pages6
JournalBone Marrow Transplantation
Volume40
Issue number4
DOIs
Publication statusPublished - Aug 2 2007

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Acute Myeloid Leukemia
Young Adult
Bone Marrow
Transplants
Survival
Methotrexate
Cyclophosphamide
Cyclosporine
Siblings
Tissue Donors
Recurrence
Mortality

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Improved outcome in young adults with de novo acute myeloid leukemia in first remission, undergoing an allogeneic bone marrow transplant. / Vicente, D.; Lamparelli, T.; Gualandi, F.; Occhini, D.; Raiola, A. M.; Ibatici, A.; Van Lint, M. T.; Gobbi, M.; Miglino, M.; Clavio, M.; Risso, M.; Frassoni, F.; Bacigalupo, A.

In: Bone Marrow Transplantation, Vol. 40, No. 4, 02.08.2007, p. 349-354.

Research output: Contribution to journalArticle

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