1. Relapse and survival after transplantation for complex karyotype acute myeloid leukemia: A report from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation and the University of Texas MD Anderson Cancer Center.
- Author
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Ciurea SO, Labopin M, Socie G, Volin L, Passweg J, Chevallier P, Beelen D, Milpied N, Blaise D, Cornelissen JJ, Fegueux N, Polge E, Kongtim P, Rondon G, Esteve J, Mohty M, Savani BN, Champlin RE, and Nagler A
- Subjects
- Adult, Aged, Chromosome Aberrations, Databases, Factual statistics & numerical data, Disease-Free Survival, Female, Graft vs Host Disease prevention & control, HLA Antigens immunology, Hematopoietic Stem Cell Transplantation methods, Hematopoietic Stem Cell Transplantation statistics & numerical data, Histocompatibility Testing, Humans, Karyotype, Karyotyping, Leukemia, Myeloid, Acute genetics, Leukemia, Myeloid, Acute mortality, Male, Middle Aged, Neoplasm Recurrence, Local prevention & control, Neoplasms, Second Primary genetics, Neoplasms, Second Primary mortality, Retrospective Studies, Texas epidemiology, Tissue Donors statistics & numerical data, Transplantation Conditioning methods, Transplantation Conditioning statistics & numerical data, Transplantation, Homologous adverse effects, Transplantation, Homologous methods, Transplantation, Homologous statistics & numerical data, Young Adult, Hematopoietic Stem Cell Transplantation adverse effects, Leukemia, Myeloid, Acute therapy, Neoplasm Recurrence, Local epidemiology, Neoplasms, Second Primary therapy
- Abstract
Background: Despite recent advances in allogeneic hematopoietic stem cell transplantation (AHSCT), the outcome of patients who have acute myeloid leukemia (AML) with a complex karyotype (CK) remains poor. The objective of this study was to identify prognostic factors associated with post-transplantation survival in a large cohort of patients with CK AML., Methods: In total, data on 1342 consecutively patients who underwent transplantation for CK (≥3 chromosomal abnormalities) AML were provided by the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation and from the University of Texas MD Anderson Cancer Center database were included in the analysis. The median patient age was 52 years. The donors were human leukocyte antigen-matched related donors (N = 749), matched unrelated donors (N = 513), and mismatched unrelated donors (N = 80)., Results: Relapse was the main cause of treatment failure. Overall, 51% of patients relapsed, 17.6% died of treatment-related mortality, and 31.3% survived leukemia-free. In multivariate analysis, the factors associated with an increased risk of relapse were age (>40 years; hazard ratio [HR], 1.1 per 10 years; P = .02), secondary AML (HR, 1.35; P = .01), active disease at transplantation (HR, 1.98; P < .001), and deletion/monosomy 5 (HR, 1.5; P < .001); whereas age (HR, 1.15 per 10 years; P < .001), secondary AML (HR, 1.36; P = .001), active disease at transplantation (HR, 1.99; P < .001), deletion/monosomy 5 (HR, 1.24; P = .008), and deletion/monosomy 7 (HR, 1.44; P < .001) predicted for leukemia-free survival., Conclusions: Disease relapse remains the most common cause of treatment failure for patients with CK AML after transplantation. Novel approaches to decrease the relapse rate and improve survival are needed in these patients. Cancer 2018;124:2134-41. © 2018 American Cancer Society., (© 2018 American Cancer Society.)
- Published
- 2018
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