Long-term follow-up of patients with acute myeloid leukemia surviving and free of disease recurrence for at least 2 years after autologous stem cell transplantation

A report from the acute leukemia working party of the European Society for Blood and Marrow Transplantation

Tomasz Czerw, Myriam Labopin, Norbert Claude Gorin, Sebastian Giebel, Didier Blaise, Giovanna Meloni, Arnaud Pigneux, Alberto Bosi, Joan Veelken, Felicetto Ferrara, Nicolaas Schaap, Roberto M. Lemoli, Jan J. Cornelissen, Eric Beohou, Arnon Nagler, Mohamad Mohty

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

BACKGROUND: Leukemia recurrence is a major cause of treatment failure after autologous stem cell transplantation for acute myeloid leukemia (AML). It usually occurs within the first 2 years after transplantation. The goal of the current retrospective study was to assess the follow-up of and characterize risk factors for outcome among patients who survived free of disease recurrence after this period. METHODS: The analysis included 3567 adults (median age, 45 years) with AML who underwent autografting during the first (86% of patients) or second (14% of patients) complete remission between 1990 and 2008. The stem cell source was the bone marrow in 32% of patients or the peripheral blood in 68% of patients. The median follow-up was 6.9 years. RESULTS: At 5 years and 10 years after transplantation, the probability of leukemia-free survival was 86% and 76%, respectively; the recurrence incidence was 11% and 16%, respectively; and the nonrecurrence mortality rate was 3% and 8%, respectively. The observed survival was decreased compared with the expected survival of the general European population. In a multivariate analysis, decreased probability of leukemia-free survival was demonstrated for patients who underwent peripheral blood autologous stem cell transplantation; had French-American-British subtypes M0, M6, or M7; and were of an older age. The same factors were found to be associated with an increased risk of disease recurrence. Nonrecurrence mortality was found to be affected by older age. CONCLUSIONS: The results of the current analysis indicate that late recurrences remain a major concern after autologous stem cell transplantation among patients with AML, indicating the need for close monitoring of minimal residual disease and additional leukemic control measures after transplantation.

Original languageEnglish
JournalCancer
DOIs
Publication statusAccepted/In press - 2016

Fingerprint

Stem Cell Transplantation
Acute Myeloid Leukemia
Leukemia
Transplantation
Bone Marrow
Recurrence
Survival
Peripheral Blood Stem Cell Transplantation
Mortality
Autologous Transplantation
Residual Neoplasm
Treatment Failure
Stem Cells
Multivariate Analysis
Retrospective Studies
Incidence
Population

Keywords

  • Acute myeloid leukemia (AML)
  • Autologous transplantation
  • Follow-up
  • Recurrence
  • Risk factors
  • Stem cell transplantation

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Long-term follow-up of patients with acute myeloid leukemia surviving and free of disease recurrence for at least 2 years after autologous stem cell transplantation : A report from the acute leukemia working party of the European Society for Blood and Marrow Transplantation. / Czerw, Tomasz; Labopin, Myriam; Gorin, Norbert Claude; Giebel, Sebastian; Blaise, Didier; Meloni, Giovanna; Pigneux, Arnaud; Bosi, Alberto; Veelken, Joan; Ferrara, Felicetto; Schaap, Nicolaas; Lemoli, Roberto M.; Cornelissen, Jan J.; Beohou, Eric; Nagler, Arnon; Mohty, Mohamad.

In: Cancer, 2016.

Research output: Contribution to journalArticle

Czerw, Tomasz ; Labopin, Myriam ; Gorin, Norbert Claude ; Giebel, Sebastian ; Blaise, Didier ; Meloni, Giovanna ; Pigneux, Arnaud ; Bosi, Alberto ; Veelken, Joan ; Ferrara, Felicetto ; Schaap, Nicolaas ; Lemoli, Roberto M. ; Cornelissen, Jan J. ; Beohou, Eric ; Nagler, Arnon ; Mohty, Mohamad. / Long-term follow-up of patients with acute myeloid leukemia surviving and free of disease recurrence for at least 2 years after autologous stem cell transplantation : A report from the acute leukemia working party of the European Society for Blood and Marrow Transplantation. In: Cancer. 2016.
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abstract = "BACKGROUND: Leukemia recurrence is a major cause of treatment failure after autologous stem cell transplantation for acute myeloid leukemia (AML). It usually occurs within the first 2 years after transplantation. The goal of the current retrospective study was to assess the follow-up of and characterize risk factors for outcome among patients who survived free of disease recurrence after this period. METHODS: The analysis included 3567 adults (median age, 45 years) with AML who underwent autografting during the first (86{\%} of patients) or second (14{\%} of patients) complete remission between 1990 and 2008. The stem cell source was the bone marrow in 32{\%} of patients or the peripheral blood in 68{\%} of patients. The median follow-up was 6.9 years. RESULTS: At 5 years and 10 years after transplantation, the probability of leukemia-free survival was 86{\%} and 76{\%}, respectively; the recurrence incidence was 11{\%} and 16{\%}, respectively; and the nonrecurrence mortality rate was 3{\%} and 8{\%}, respectively. The observed survival was decreased compared with the expected survival of the general European population. In a multivariate analysis, decreased probability of leukemia-free survival was demonstrated for patients who underwent peripheral blood autologous stem cell transplantation; had French-American-British subtypes M0, M6, or M7; and were of an older age. The same factors were found to be associated with an increased risk of disease recurrence. Nonrecurrence mortality was found to be affected by older age. CONCLUSIONS: The results of the current analysis indicate that late recurrences remain a major concern after autologous stem cell transplantation among patients with AML, indicating the need for close monitoring of minimal residual disease and additional leukemic control measures after transplantation.",
keywords = "Acute myeloid leukemia (AML), Autologous transplantation, Follow-up, Recurrence, Risk factors, Stem cell transplantation",
author = "Tomasz Czerw and Myriam Labopin and Gorin, {Norbert Claude} and Sebastian Giebel and Didier Blaise and Giovanna Meloni and Arnaud Pigneux and Alberto Bosi and Joan Veelken and Felicetto Ferrara and Nicolaas Schaap and Lemoli, {Roberto M.} and Cornelissen, {Jan J.} and Eric Beohou and Arnon Nagler and Mohamad Mohty",
year = "2016",
doi = "10.1002/cncr.29990",
language = "English",
journal = "Cancer",
issn = "0008-543X",
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TY - JOUR

T1 - Long-term follow-up of patients with acute myeloid leukemia surviving and free of disease recurrence for at least 2 years after autologous stem cell transplantation

T2 - A report from the acute leukemia working party of the European Society for Blood and Marrow Transplantation

AU - Czerw, Tomasz

AU - Labopin, Myriam

AU - Gorin, Norbert Claude

AU - Giebel, Sebastian

AU - Blaise, Didier

AU - Meloni, Giovanna

AU - Pigneux, Arnaud

AU - Bosi, Alberto

AU - Veelken, Joan

AU - Ferrara, Felicetto

AU - Schaap, Nicolaas

AU - Lemoli, Roberto M.

AU - Cornelissen, Jan J.

AU - Beohou, Eric

AU - Nagler, Arnon

AU - Mohty, Mohamad

PY - 2016

Y1 - 2016

N2 - BACKGROUND: Leukemia recurrence is a major cause of treatment failure after autologous stem cell transplantation for acute myeloid leukemia (AML). It usually occurs within the first 2 years after transplantation. The goal of the current retrospective study was to assess the follow-up of and characterize risk factors for outcome among patients who survived free of disease recurrence after this period. METHODS: The analysis included 3567 adults (median age, 45 years) with AML who underwent autografting during the first (86% of patients) or second (14% of patients) complete remission between 1990 and 2008. The stem cell source was the bone marrow in 32% of patients or the peripheral blood in 68% of patients. The median follow-up was 6.9 years. RESULTS: At 5 years and 10 years after transplantation, the probability of leukemia-free survival was 86% and 76%, respectively; the recurrence incidence was 11% and 16%, respectively; and the nonrecurrence mortality rate was 3% and 8%, respectively. The observed survival was decreased compared with the expected survival of the general European population. In a multivariate analysis, decreased probability of leukemia-free survival was demonstrated for patients who underwent peripheral blood autologous stem cell transplantation; had French-American-British subtypes M0, M6, or M7; and were of an older age. The same factors were found to be associated with an increased risk of disease recurrence. Nonrecurrence mortality was found to be affected by older age. CONCLUSIONS: The results of the current analysis indicate that late recurrences remain a major concern after autologous stem cell transplantation among patients with AML, indicating the need for close monitoring of minimal residual disease and additional leukemic control measures after transplantation.

AB - BACKGROUND: Leukemia recurrence is a major cause of treatment failure after autologous stem cell transplantation for acute myeloid leukemia (AML). It usually occurs within the first 2 years after transplantation. The goal of the current retrospective study was to assess the follow-up of and characterize risk factors for outcome among patients who survived free of disease recurrence after this period. METHODS: The analysis included 3567 adults (median age, 45 years) with AML who underwent autografting during the first (86% of patients) or second (14% of patients) complete remission between 1990 and 2008. The stem cell source was the bone marrow in 32% of patients or the peripheral blood in 68% of patients. The median follow-up was 6.9 years. RESULTS: At 5 years and 10 years after transplantation, the probability of leukemia-free survival was 86% and 76%, respectively; the recurrence incidence was 11% and 16%, respectively; and the nonrecurrence mortality rate was 3% and 8%, respectively. The observed survival was decreased compared with the expected survival of the general European population. In a multivariate analysis, decreased probability of leukemia-free survival was demonstrated for patients who underwent peripheral blood autologous stem cell transplantation; had French-American-British subtypes M0, M6, or M7; and were of an older age. The same factors were found to be associated with an increased risk of disease recurrence. Nonrecurrence mortality was found to be affected by older age. CONCLUSIONS: The results of the current analysis indicate that late recurrences remain a major concern after autologous stem cell transplantation among patients with AML, indicating the need for close monitoring of minimal residual disease and additional leukemic control measures after transplantation.

KW - Acute myeloid leukemia (AML)

KW - Autologous transplantation

KW - Follow-up

KW - Recurrence

KW - Risk factors

KW - Stem cell transplantation

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U2 - 10.1002/cncr.29990

DO - 10.1002/cncr.29990

M3 - Article

JO - Cancer

JF - Cancer

SN - 0008-543X

ER -