Inferior outcome of allogeneic stem cell transplantation for secondary acute myeloid leukemia in first complete remission as compared to de novo acute myeloid leukemia

被引:0
作者
Ann-Kristin Schmaelter
Myriam Labopin
Gerard Socié
Maija Itälä-Remes
Didier Blaise
Ibrahim Yakoub-Agha
Edouard Forcade
Jan Cornelissen
Arnold Ganser
Dietrich Beelen
Hélène Labussière-Wallet
Jakob Passweg
Bipin N. Savani
Christoph Schmid
Arnon Nagler
Mohamad Mohty
机构
[1] Augsburg University Hospital,Department of Hematology and Oncology
[2] Saint Antoine Hospital,Department of Haematology
[3] Université Pierre et Marie Curie,Programme de Transplantation & Therapie Cellulaire
[4] EBMT Paris study office/ CEREST-TC,Division of Hematology/Oncology
[5] Hopital St. Louis,Hematology Division
[6] Dept.of Hematology – BMT,undefined
[7] HUCH Comprehensive Cancer Center,undefined
[8] Stem Cell Transplantation Unit,undefined
[9] Centre de Recherche en Cancérologie de Marseille,undefined
[10] Institut Paoli Calmettes,undefined
[11] CHU de Lille,undefined
[12] LIRIC,undefined
[13] INSERM U995,undefined
[14] Université de Lille,undefined
[15] CHU Bordeaux Hôpital Haut-Leveque,undefined
[16] Erasmus MC Cancer Institute,undefined
[17] University Medical Center Rotterdam,undefined
[18] Department of Hematology,undefined
[19] Hannover Medical School,undefined
[20] Department of Haematology,undefined
[21] Hemostasis,undefined
[22] Oncology and Stem Cell Transplantation,undefined
[23] University Hospital,undefined
[24] Department of Bone Marrow Transplantation,undefined
[25] Centre Hospitalier Lyon Sud,undefined
[26] Service Hematologie,undefined
[27] University Hospital,undefined
[28] Hematology,undefined
[29] Vanderbilt University Medical Center,undefined
[30] Chaim Sheba Medical Center,undefined
来源
Blood Cancer Journal | / 10卷
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摘要
Following chemotherapy, secondary acute myeloid leukemia (sAML), occurring after antecedent hematologic diseases, previous chemotherapy or radiation, has an inferior prognosis compared with de novo AML. To define the outcome of sAML in the context of allogeneic stem cell transplantation (alloSCT), a retrospective, registry-based comparison was performed, including 11,439 patients with de novo and 1325 with sAML. Among transplants in first complete remission (CR1) (n = 8,600), the 3-year cumulative incidence of relapse (RI) and non-relapse mortality (NRM) was 28.5% and 16.4% for de novo, and 35% and 23.4% for sAML. Three-year overall survival (OS), leukemia-free survival (LFS) and Graft-versus-Host Disease/relapse-free survival (GRFS) was 60.8%, 55.1%, and 38.6% for de novo, and 46.7%, 41.6%, and 28.4% for sAML, respectively. In multivariate analysis, sAML was associated with a lower OS (HR = 1.33 [95% CI = 1.21–1.48]; p < 10−5), LFS (HR = 1.32 [95% CI = 1.19–1.45]; p < 10−5) and GRFS (HR = 1.2 [95% CI = 1.1–1.31]; p < 10−4) and higher NRM (HR = 1.37 [95% CI = 1.17–1.59]; p < 10−4) and RI (HR = 1.27 [95% CI = 1.12–1.44]; p < 10−3). Results of the Cox model were confirmed in a matched-pair analysis. In contrast, results did not differ between de novo and sAML after alloSCT in induction failure or relapse. Hence, this analysis identified sAML as an independent risk factor for outcome after alloSCT in CR1.
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