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Allogeneic stem cell transplantation for refractory acute myeloid leukemia: a single center analysis of long-term outcome

Item Type:Article
Title:Allogeneic stem cell transplantation for refractory acute myeloid leukemia: a single center analysis of long-term outcome
Creators Name:Hemmati, P.G. and Terwey, T.H. and Na, I.K. and Jehn, C.F. and le Coutre, P. and Vuong, L.G. and Doerken, B. and Arnold, R.
Abstract:For patients with refractory acute myeloid leukemia (AML) allogeneic stem cell transplantation (alloSCT) represents the only curative approach. We here analyzed the long-term outcome of 131 consecutive patients with active AML, which was either primary refractory or unresponsive to salvage chemotherapy, transplanted at our center between 1997 and 2013. After a median follow-up of 48 months for the surviving patients, disease-free survival (DFS) at 5 years post alloSCT was 26% (94% CI: 17-35%). Relapses, most of which occurred within the first 2 years from transplant, were the predominant cause of treatment failure affecting 48% (95% CI: 40-58%) of patients, whereas non-relapse mortality was 26% (95% CI: 20-36%) at 5 years and thereafter. A marrow blast count ≥20% before alloSCT was an independent prognosticator associated with an inferior DFS (HR: 1.58, p=0.027), whereas the development of chronic graft-versus-host disease (cGvHD) predicted an improved DFS (HR 0.21, p<0.001) and a decreased relapse incidence (HR: 0.18, p=0.026), respectively. These results indicate that alloSCT represents a curative treatment option in a substantial proportion of patients with refractory AML. A pre-transplant blast count <20% before alloSCT and the development of cGvHD are the most important predictors of long-term disease control.
Keywords:Allogeneic Stem Cell Transplantation, Acute Myeloid Leukemia, Refractory Disease, Graft-versus-Host Disease, Reduced-Intensity Conditioning
Source:European Journal of Haematology
ISSN:0902-4441
Publisher:Wiley-Blackwell (Denmark)
Volume:95
Number:6
Page Range:498-506
Date:December 2015
Official Publication:https://doi.org/10.1111/ejh.12522
PubMed:View item in PubMed

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