Allogeneic Hematopoietic Stem Cell Transplantation Following the Use of Hypomethylating Agents among Patients with Relapsed or Refractory AML: Findings from an International Retrospective Study

被引：5

作者：

Stahl, Maximilian ^{[1
]}

DeVeaux, Michelle ^{[2
]}

Montesinos, Pau ^{[3
,4
]}

Itzykson, Raphael ^{[5
]}

Ritchie, Ellen K. ^{[6
,7
]}

Sekeres, Mikkael A. ^{[8
]}

Majhail, Navneet ^{[8
]}

Barnard, John ^{[8
]}

Podoltsev, Nikolai A. ^{[1
]}

Brunner, Andrew M. ^{[9
]}

Komrokji, Rami S. ^{[10
]}

Bhatt, Vijaya R. ^{[11
]}

Al-Kali, Aref ^{[12
]}

Cluzeau, Thomas ^{[13
,14
]}

Santini, Valeria ^{[15
]}

Roboz, Gail J. ^{[6
,7
]}

Fenaux, Pierre

Litzow, Mark ^{[12
]}

Fathi, Amir T. ^{[9
]}

Perreault, Sarah ^{[16
]}

Kim, Tae Kon ^{[1
]}

Prebet, Thomas ^{[1
]}

Vey, Norbert ^{[17
]}

Verma, Vivek ^{[11
]}

Kobbe, Guido ^{[18
]}

Bergua, Juan ^{[19
]}

Serrano, Josefina ^{[20
]}

Gore, Steven D. ^{[1
]}

Zeidan, Amer M. ^{[1
]}

机构：

[1] Yale Univ, Sch Med, Dept Internal Med, Sect Hematol, New Haven, CT 06510 USA

[2] Yale Sch Publ Hlth, Dept Biostat, New Haven, CT USA

[3] Univ Valencia, Dept Med, Hosp Univ & Politecn La Fe, Valencia, Spain

[4] Inst Carlos III, CIBERONC, Madrid, Spain

[5] Univ Paris 07, St Louis Hosp, Paris, France

[6] Weill Cornell Med, Div Hematol & Oncol, New York, NY USA

[7] New York Presbyterian Hosp, New York, NY USA

[8] Cleveland Clin, Leukemia Program, Cleveland, OH 44106 USA

[9] Harvard Med Sch, Massachusetts Gen Hosp, Ctr Canc, Boston, MA USA

[10] H Lee Moffitt Canc Ctr & Res Inst, Dept Malignant Hematol, Tampa, FL USA

[11] Univ Nebraska Med Ctr, Div Hematol Oncol, Omaha, NE USA

[12] Mayo Clin, Div Hematol, Rochester, MN USA

[13] Nice Sophia Antipolis Univ, CHU Nice, Cote dAzur Univ, Nice, France

[14] Mediterranean Ctr Mol Med, INSERM U1065, Nice, France

[15] Univ Florence, Div Hematol, Florence, Italy

[16] Yale New Haven Med Ctr, Dept Pharm, 20 York St, New Haven, CT 06504 USA

[17] Inst Paoli Calmettes, Dept Hematol, Marseille, France

[18] Heinrich Heine Univ Dusseldorf, Dept Hematol Oncol & Clin Immunol, Dusseldorf, Germany

[19] Hosp San Pedro Alcantara, Div Hematol Oncol, Caceres, Spain

[20] Univ Hosp Reina Sofia, Div Hematol Oncol, Cordoba, Spain

来源：

BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION | 2018年 / 24卷 / 08期

关键词：

Survival; Hypomethylating agents; Transplant; AML; ACUTE MYELOID-LEUKEMIA;

D O I：

10.1016/j.bbmt.2018.03.025

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Patients with primary refractory or relapsed acute myeloid leukemia (RR-AML) have very poor prognosis. Due to limited treatment options, some patients are treated with hypomethylating agents (HMAs) due to their tolerability. Little is known about the role of allogeneic hematopoietic stem cell transplantation (HSCT) following HMA therapy in this setting. We retrospectively analyzed an international cohort of 655 RR-AML patients who received HMA therapy to study patterns and outcomes with HSCT. Only 37 patients (5.6%) patients underwent HSCT after HMA therapy. The conditioning regimen was myeloablative in 57% and nonmyeloablative in 43%. Patients received matched unrelated donor, matched sibling, haploidentical and mismatched unrelated HSCT in 56%, 24%, 16% and 4% of cases, respectively. Acute GvHD and chronic GvHD were observed in 40% and 17% of patients. While the median OS for the entire cohort of patients was 15.3 months (95% CI 9.5 - 21.7 months), OS reached 29.7 months (95% CI 7.01 - not-reached) for patients who achieved a complete remission (CR) to HMA and no intervening therapies between HMA therapy and HSCT. Our study suggests that HMA therapy can effectively bridge some patients with RR-AML to HSCT. (C) 2018 American Society for Blood and Marrow Transplantation.

引用

页码：1754 / 1758

页数：5

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