Long-term survival and late events after allogeneic stem cell transplantation from HLA-matched siblings for acute myeloid leukemia with myeloablative compared to reduced-intensity conditioning: a report on behalf of the acute leukemia working party of European group for blood and marrow transplantation

Andrea Bacigalupo, Avichai Shimoni, Myriam Labopin, Bipin Savani, Liisa Volin, Gerhard Ehninger, Jurgen Kuball, Donald Bunjes, Nicolaas Schaap, Stephane Vigouroux, Hendrik Veelken, Jorge Sierra, Matthias Eder, Dietger Niederwieser, Mohamad Mohty, Arnon Nagler

Risultato della ricerca: Contributo in rivistaArticolo in rivista

33 Citazioni (Scopus)

Abstract

Background: Myeloablative (MAC) and reduced-intensity conditioning (RIC) are established approaches for allogeneic stem cell transplantation (SCT) in acute myeloid leukemia (AML). Most deaths after MAC occur within the first 2 years after SCT, while patients surviving leukemia-free for 2 years can expect a favorable long-term outcome. However, there is paucity of data on the long-term outcome (beyond 10 years) and the pattern of late events following RIC due to the relative recent introduction of this approach. Methods: We analyzed long-term outcomes in a cohort of 1423 AML patients, age ≥50 years, after SCT from HLA-matched siblings, during the years 1997-2005, median follow-up 8.3 years (0.1-17). Results: The 10-year leukemia-free survival (LFS) was 31 % (95CI, 27-35) and 32 % (28-35) after MAC and RIC, respectively (P = 0.57). The 10-year GVHD/ relapse-free survival (GRFS), a surrogate for quality of life was 22 % (18-25) and 21 % (18-24), respectively (P = 0.79). The 10-year non-relapse mortality (NRM) was higher and relapse rate was lower after MAC, throughout the early and late post-transplant course. The 10-year LFS among 584 patients surviving leukemia-free 2 years after SCT was 71 % (65-76) and 73 % (67-78) after MAC and RIC, respectively (P = 0.76). Advanced leukemia at SCT was the major predictor of LFS subsequent to the 2-year landmark. Relapse was the major cause of late death after both regimens; however, NRM and in particular chronic graft-versus-host disease and second cancers were more common causes of late death after MAC. Conclusions: Long-term LFS and GRFS are similar after RIC and MAC. Most events after RIC or MAC occur within the first 2 years after SCT. Patients who are leukemia-free 2 years after SCT can expect similar good subsequent outcome after both approaches.
Lingua originaleEnglish
pagine (da-a)118-118
Numero di pagine1
RivistaJOURNAL OF HEMATOLOGY & ONCOLOGY
Volume9
DOI
Stato di pubblicazionePubblicato - 2016

Keywords

  • Acute myeloid leukemia
  • Allogeneic stem cell transplantation
  • Cancer Research
  • Hematology
  • Long-term outcome
  • Molecular Biology
  • Myeloablative conditioning
  • Oncology
  • Reduced-intensity conditioning

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