Outcome of relapse after allogeneic stem cell transplant in patients with acute myeloid leukemia

Raynier Devillier, Roberto Crocchiolo, Anne Etienne, Thomas Prebet, Aude Charbonnier, Sabine Fürst, Jean El-Cheikh, Evelyne D'Incan, Jérôme Rey, Catherine Faucher, Didier Blaise, Norbert Vey

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Although allogeneic stem cell transplant (Allo-SCT) is an effective treatment for high-risk acute myeloid leukemia (AML), relapses remain a major cause of treatment failure. There is currently no standard of care for post-transplant relapse of AML, but the increasing numbers of investigational agents in this setting require a better knowledge of their outcome. We retrospectively evaluated the efficacy of salvage therapies in 54 patients with AML relapsing after Allo-SCT. Twenty-four patients received intensive salvage treatment (17 non-intensive chemotherapy, 13 supportive care). Complete remissions (CRs) were seen only in the group who received intensive salvage (CR rate: 17/24 [71%]). One-year overall survival was 19% (median: 3.4 months) in the whole study group and 33% in the intensive savage group (vs. 7% for patients without intensive salvage, p = 0.004). Factors influencing overall survival (OS) were: time to relapse after Allo-SCT (hazard ratio [HR]: 3.7 [1.6-8.8]) and performance status (PS) at relapse (HR: 2.2 [1.1-4.4]) by multivariate analysis. Our results confirm the poor prognosis of AML relapse after Allo-SCT. In selected patients salvage chemotherapy produces CRs, but these are short lived. Other strategies aiming at modulating immune antileukemic activity have to be developed.

Original languageEnglish
Pages (from-to)1228-1234
Number of pages7
JournalLeukemia and Lymphoma
Volume54
Issue number6
DOIs
Publication statusPublished - Jun 2013

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Acute Myeloid Leukemia
Stem Cells
Transplants
Recurrence
Salvage Therapy
Drug Therapy
Survival
Standard of Care
Treatment Failure
Multivariate Analysis
Therapeutics

Keywords

  • Acute myeloid leukemia
  • Allogeneic stem cell transplantation
  • Relapse

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

Outcome of relapse after allogeneic stem cell transplant in patients with acute myeloid leukemia. / Devillier, Raynier; Crocchiolo, Roberto; Etienne, Anne; Prebet, Thomas; Charbonnier, Aude; Fürst, Sabine; El-Cheikh, Jean; D'Incan, Evelyne; Rey, Jérôme; Faucher, Catherine; Blaise, Didier; Vey, Norbert.

In: Leukemia and Lymphoma, Vol. 54, No. 6, 06.2013, p. 1228-1234.

Research output: Contribution to journalArticle

Devillier, R, Crocchiolo, R, Etienne, A, Prebet, T, Charbonnier, A, Fürst, S, El-Cheikh, J, D'Incan, E, Rey, J, Faucher, C, Blaise, D & Vey, N 2013, 'Outcome of relapse after allogeneic stem cell transplant in patients with acute myeloid leukemia', Leukemia and Lymphoma, vol. 54, no. 6, pp. 1228-1234. https://doi.org/10.3109/10428194.2012.741230
Devillier, Raynier ; Crocchiolo, Roberto ; Etienne, Anne ; Prebet, Thomas ; Charbonnier, Aude ; Fürst, Sabine ; El-Cheikh, Jean ; D'Incan, Evelyne ; Rey, Jérôme ; Faucher, Catherine ; Blaise, Didier ; Vey, Norbert. / Outcome of relapse after allogeneic stem cell transplant in patients with acute myeloid leukemia. In: Leukemia and Lymphoma. 2013 ; Vol. 54, No. 6. pp. 1228-1234.
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