Longitudinal Outcome over Two Decades of Unrelated Allogeneic Stem Cell Transplantation for Relapsed/Refractory Acute Myeloid Leukemia: An ALWP/EBMT Analysis

Nagler, Arnon; Ngoya, Maud; Galimard, Jacques-Emmanuel; Labopin, Myriam; Bornhäuser, Martin; Stelljes, Matthias; Finke, Jürgen; Ganser, Arnold; Einsele, Herman; Kröger, Nicolaus; Brecht, Arne; Bethge, Wolfgang; Edinger, Matthias; Kulagin, Aleksandr; Passweg, Jakob; Blau, Igor Wolfgang; Elmaagacli, Ahmet; Schäfer-Eckart, Kerstin; Platzbecker, Uwe; Schroeder, Thomas; Bunjes, Donald; Tischer, Johanna; Martin, Sonja; Spyridonidis, Alexandros; Giebel, Sebastian; Savani, Bipin und Mohty, Mohamad (2022): Longitudinal Outcome over Two Decades of Unrelated Allogeneic Stem Cell Transplantation for Relapsed/Refractory Acute Myeloid Leukemia: An ALWP/EBMT Analysis. In: Clinical Cancer Research, Bd. 28, Nr. 19: S. 4258-4266

Abstract

Purpose: We evaluated outcomes of unrelated transplantation for primary refractory/relapsed (ref/rel) acute myeloid leukemia (AML), comparing two cohorts according to the year of transplant, 2000-2009 and 2010-2019.Patients and Methods: Multivariable analyses were performed using the Cox proportional-hazards regression model.Results: 3,430 patients were included;876 underwent a trans-plant between 2000-2009 and 2554 in 2010-2019. Median follow-up was 8.7 (95% CI, 7.8-9.4) and 3.4 (95% CI, 3.1-3.6) years (P < 0.001). Median age was 52 (18-77) and 56 (18-79) years (P > 0.0001);45.5% and 55.5% had refractory AML while 54.5% and 44.5% had relapsed AML. Conditioning was myeloablative in 60% and 52%, respectively. Neutrophil recovery and day 100 incidence of acute and 2-year incidence of chronic graft-versus-host disease (GvHD) were similar between the two periods. Two-year relapse incidence was higher for patients undergoing transplant in the 2000-2009 period versus those undergoing transplant in 2010- 2019: 50.2% versus 45.1% (HR, 0.85;95% CI, 0.74-0.97;P = 0.002). Leukemia-free survival;overall survival;and GvHD-free, relapse-free survival were lower for the 2000-2009 period: 26% versus 32.1% (HR, 0.87;95% CI, 0.78-0.97;P = 0.01), 32.1% versus 38.1% (HR, 0.86;95% CI, 0.77-0.96;P = 0.01), and 21.5% versus 25.3% (HR, 0.89;95% CI, 0.81-0.99;P = 0.03), respectively. Two-year non-relapse mortality was not significantly different (23.8% vs. 23.7%;HR, 0.91;95% CI, 0.76-1.11;P = 0.34).Conclusions: Outcome of unrelated transplantation for patients with ref/rel AML has improved in the last two decades, rescuing about one third of the patients.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 1078-0432
• Sprache: Englisch