Allogeneic hematopoietic cell transplant for AML: no impact of pre-transplant extramedullary disease on outcome

被引:0
作者
S D Goyal
M-J Zhang
H-L Wang
G Akpek
E A Copelan
C Freytes
R P Gale
M Hamadani
Y Inamoto
R T Kamble
H M Lazarus
D I Marks
T Nishihori
R F Olsson
R Reshef
D S Ritchie
W Saber
B N Savani
A Seber
T C Shea
M S Tallman
B Wirk
D W Bunjes
S M Devine
M de Lima
D J Weisdorf
G L Uy
机构
[1] St Louis University Medical Center,Department of Medicine
[2] Center for International Blood and Marrow Transplant Research,Division of Biostatistics
[3] Medical College of Wisconsin,Department of Hematologic Oncology and Blood Disorders
[4] Institute for Health and Society,Division of Experimental Medicine, Department of Medicine
[5] Medical College of Wisconsin,Division of Hematology and Oncology
[6] Section of Hematology Oncology,Department of Blood and Marrow Transplantation
[7] Banner MD Anderson Cancer Center,Division of Therapeutic Immunology, Department of Laboratory Medicine
[8] Levine Cancer Institute,Department of Medicine
[9] Carolinas HealthCare System,Division of Hematology/Oncology, Department of Medicine
[10] South Texas Veterans Health Care System and University of Texas Health Science Center San Antonio,Division of Hematology and Oncology, Department of Medicine
[11] Hematology Research Centre,Department of Medicine
[12] Imperial College London,Department of Internal Medicine
[13] National Cancer Center Hospital,Department of Internal Medicine III
[14] Center for Cell and Gene Therapy,Department of Internal Medicine
[15] Baylor College of Medicine,Division of Hematology, Department of Medicine
[16] Seidman Cancer Center,Department of Medicine
[17] University Hospitals Case Medical Center,undefined
[18] Pediatric Bone Marrow Transplant,undefined
[19] University Hospitals Bristol NHS Trust,undefined
[20] H. Lee Moffitt Cancer Center and Research Institute,undefined
[21] Karolinska Institutet,undefined
[22] Centre for Clinical Research Sörmland,undefined
[23] Uppsala University,undefined
[24] Abramson Cancer Center,undefined
[25] University of Pennsylvania Medical Center,undefined
[26] Royal Melbourne Hospital,undefined
[27] Vanderbilt University Medical Center,undefined
[28] Hospital Samaritano,undefined
[29] University of North Carolina Health Care,undefined
[30] Leukemia Service,undefined
[31] Memorial Sloan Kettering Cancer Center,undefined
[32] Stony Brook University Medical Center,undefined
[33] Universitätsklinikum Ulm,undefined
[34] The Ohio State University Comprehensive Cancer Center—James,undefined
[35] Oncology and Transplantation,undefined
[36] University of Minnesota Medical Center,undefined
[37] Washington University School of Medicine,undefined
来源
Bone Marrow Transplantation | 2015年 / 50卷
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摘要
The impact of extramedullary disease (EMD) in AML on the outcomes of allogeneic hematopoietic cell transplantation (alloHCT) is unknown. Using data from the Center for International Blood and Marrow Transplant Research, we compared the outcomes of patients who had EMD of AML at any time before transplant, with a cohort of AML patients without EMD. We reviewed data from 9797 AML patients including 814 with EMD from 310 reporting centers and 44 different countries, who underwent alloHCT between and 1995 and 2010. The primary outcome was overall survival (OS) after alloHCT. Secondary outcomes included leukemia-free survival (LFS), relapse rate and treatment-related mortality (TRM). In a multivariate analysis, the presence of EMD did not affect either OS (hazard ratio 1.00, 95% confidence interval (CI) 0.91–1.09), LFS (0.98, 0.89–1.09), TRM (relative risk 0.92, 95% CI 0.80–1.16, P=0.23) or relapse (relative risk=1.03, 95% CI, 0.92–1.16; P=0.62). Furthermore, the outcome of patients with EMD was not influenced by the location, timing of EMD, or intensity of conditioning regimen. The presence of EMD in AML does not affect transplant outcomes and should not be viewed as an independent adverse prognostic feature.
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页码:1057 / 1062
页数:5
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