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RESEARCH PRODUCT
Allogeneic Hematopoietic Stem Cell Transplantation Following the Use of Hypomethylating Agents among Patients with Relapsed or Refractory AML: Findings from an International Retrospective Study
John BarnardVey NorbertAmer M. ZeidanTae Kon KimThomas CluzeauThomas CluzeauMark R. LitzowRami S. KomrokjiPierre FenauxAref Al-kaliEllen K. RitchieNavneet S. MajhailThomas PrebetVijaya Raj BhattMaximilian StahlNikolai A. PodoltsevRaphael ItzyksonJosefina SerranoSarah PerreaultSteven D. GoreMikkael A. SekeresAndrew M. BrunnerValeria SantiniMichelle DeveauxVivek VermaGail J. RobozJuan BerguaAmir T. FathiPau MontesinosPau MontesinosGuido Kobbesubject
AdultMalemedicine.medical_specialtyAntimetabolites AntineoplasticTransplantation ConditioningSurvivalmedicine.medical_treatmentSalvage therapyGraft vs Host DiseaseHypomethylating agentsHematopoietic stem cell transplantationTransplant03 medical and health sciences0302 clinical medicineRefractoryAMLimmune system diseasesInternal medicinehemic and lymphatic diseasesmedicineHumansTransplantation HomologousSurvival analysisAgedRetrospective StudiesSalvage TherapyTransplantationAML; Hypomethylating agents; Survival; Transplant; Adult; Aged; Antimetabolites Antineoplastic; Female; Graft vs Host Disease; Hematopoietic Stem Cell Transplantation; Humans; Leukemia Myeloid Acute; Male; Middle Aged; Retrospective Studies; Salvage Therapy; Survival Analysis; Transplantation Conditioning; Transplantation Homologousbusiness.industryHematopoietic Stem Cell TransplantationRetrospective cohort studyHematologyMiddle AgedSurvival AnalysisLeukemia Myeloid Acutesurgical procedures operativeTolerability030220 oncology & carcinogenesisCohortFemaleTransplantation Conditioningbusiness030215 immunologydescription
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.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2018-01-01 |