Comparison of reduced-intensity hematopoietic cell transplantation with chemotherapy in patients age 60-70 years with acute myelogenous leukemia in first remission

Sherif S. Farag; Kati Maharry; Mei Jie Zhang; Waleska S. Pérez; Stephen L. George; Krzysztof Mrózek; John DiPersio; Donald W. Bunjes; Guido Marcucci; Maria R. Baer; Mitchell Cairo; Edward Copelan; Corey S. Cutler; Luis Isola; Hillard M. Lazarus; Mark R. Litzow; David I. Marks; Olle Ringdén; David A. Rizzieri; Robert Soiffer; Richard A. Larson; Martin S. Tallman; Clara D. Bloomfield; Daniel J. Weisdorf

doi:10.1016/j.bbmt.2011.06.005

Comparison of reduced-intensity hematopoietic cell transplantation with chemotherapy in patients age 60-70 years with acute myelogenous leukemia in first remission

Sherif S. Farag, Kati Maharry, Mei Jie Zhang, Waleska S. Pérez, Stephen L. George, Krzysztof Mrózek, John DiPersio, Donald W. Bunjes, Guido Marcucci, Maria R. Baer, Mitchell Cairo, Edward Copelan, Corey S. Cutler, Luis Isola, Hillard M. Lazarus, Mark R. Litzow, David I. Marks, Olle Ringdén, David A. Rizzieri, Robert SoifferRichard A. Larson, Martin S. Tallman, Clara D. Bloomfield, Daniel J. Weisdorf

Medicine - Hematology, Oncology, Transplant

Research output: Contribution to journal › Article › peer-review

100 Scopus citations

Abstract

We compared the outcomes of patients age 60-70 years with acute myelogenous leukemia receiving reduced-intensity allogeneic hematopoietic cell transplantation (HCT) in first remission (CR1) reported to the Center for International Blood and Marrow Research (n = 94) with the outcomes in patients treated with induction and postremission chemotherapy on Cancer and Leukemia Group B protocols (n = 96). All patients included had been in CR1 for at least 4 months. The HCT recipients were slightly younger than the chemotherapy patients (median age, 63 years vs 65 years; P <.001), but there were no significant between-group differences in the proportion with therapy-related leukemia or in different cytogenetic risk groups. Time from diagnosis to CR1 was longer for the HCT recipients (median, 44 days vs 38 days; P =.031). Allogeneic HCT was associated with significantly lower risk of relapse (32% vs 81% at 3 years; P <.001), higher nonrelapse mortality (36% vs 4% at 3 years; P <.001), and longer leukemia-free survival (32% vs 15% at 3 years; P =.001). Although overall survival was longer for HCT recipients, the difference was not statistically significant (37% vs 25% at 3 years; P =.08). Our findings suggest that reduced-intensity conditioning allogeneic HCT in patients age 60-70 with acute myelogenous leukemia in CR1 reduces relapse and improves leukemia-free survival. Strategies that reduce nonrelapse mortality may yield significant improvements in overall survival.

Original language	English (US)
Pages (from-to)	1796-1803
Number of pages	8
Journal	Biology of Blood and Marrow Transplantation
Volume	17
Issue number	12
DOIs	https://doi.org/10.1016/j.bbmt.2011.06.005
State	Published - Dec 2011

Bibliographical note

Funding Information:
Financial Disclosure : The Center for International Blood and Marrow Research is supported by Public Health Service Grant/Cooperative Agreement U24-CA76518 from the National Cancer Institute, National Heart, Lung and Blood Institute , and National Institute of Allergy and Infectious Diseases; Grant/Cooperative Agreement 5U01HL069294 from the National Heart, Lung and Blood Institute and National Cancer Institute ; Contract HHSH234200637015C from the Health Resources and Services Administration ; Grants N00014-06-1-0704 and N00014-08-1-0058 from the Office of Naval Research; and grants from AABB; Allos, Inc; Amgen, Inc ; Anonymous donation to the Medical College of Wisconsin; Astellas Pharma US, Inc; Be the Match Foundation; Biogen IDEC; BioMarin Pharmaceutical, Inc; Biovitrum AB; BloodCenter of Wisconsin; Blue Cross and Blue Shield Association; Bone Marrow Foundation; Buchanan Family Foundation; CaridianBCT; Celgene Corporation; CellGenix, GmbH; Children’s Leukemia Research Association; ClinImmune Labs; CTI Clinical Trial and Consulting Services; Eisai, Inc; Genentech, Inc; Genzyme Corporation; Histogenetics, Inc; HKS Medical Information Systems; Hospira, Inc; Kirin Brewery Co, Ltd; The Leukemia and Lymphoma Society; Merck & Company; The Medical College of Wisconsin; Millennium Pharmaceuticals, Inc; Miller Pharmacal Group; Milliman USA, Inc; Miltenyi Biotec, Inc; National Marrow Donor Program; Nature Publishing Group; Novartis Oncology; Oncology Nursing Society; Osiris Therapeutics, Inc; Otsuka America Pharmaceutical, Inc; Pall Life Sciences; Pfizer Inc; Schering Corporation; Sigma-Tau Pharmaceuticals; Soligenix, Inc; StemCyte, Inc; StemSoft Software, Inc; Sysmex America, Inc; THERAKOS, Inc; Vidacare Corporation; ViraCor Laboratories; ViroPharma, Inc; and Wellpoint, Inc The views expressed in this paper do not reflect the official policy or position of the National Institutes of Health, Department of the Navy, Department of Defense, or any other agency of the U.S. Government.

Funding Information:
This research was supported in part by grants from the National Cancer Institute to Cancer and Leukemia Group B ( CA101140, CA31946, CA77658, CA33601, CA41287, CA47545, CA03927, CA47577, CA35279, and CA32291), NCI CA16058 , and the Coleman Leukemia Research Fund.

Keywords

Acute myeloid leukemia
Allogeneic
Chemotherapy
Reduced-intensity

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10.1016/j.bbmt.2011.06.005

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Farag, S. S., Maharry, K., Zhang, M. J., Pérez, W. S., George, S. L., Mrózek, K., DiPersio, J., Bunjes, D. W., Marcucci, G., Baer, M. R., Cairo, M., Copelan, E., Cutler, C. S., Isola, L., Lazarus, H. M., Litzow, M. R., Marks, D. I., Ringdén, O., Rizzieri, D. A., ... Weisdorf, D. J. (2011). Comparison of reduced-intensity hematopoietic cell transplantation with chemotherapy in patients age 60-70 years with acute myelogenous leukemia in first remission. Biology of Blood and Marrow Transplantation, 17(12), 1796-1803. https://doi.org/10.1016/j.bbmt.2011.06.005

Comparison of reduced-intensity hematopoietic cell transplantation with chemotherapy in patients age 60-70 years with acute myelogenous leukemia in first remission. / Farag, Sherif S.; Maharry, Kati; Zhang, Mei Jie et al.
In: Biology of Blood and Marrow Transplantation, Vol. 17, No. 12, 12.2011, p. 1796-1803.

Research output: Contribution to journal › Article › peer-review

Farag, SS, Maharry, K, Zhang, MJ, Pérez, WS, George, SL, Mrózek, K, DiPersio, J, Bunjes, DW, Marcucci, G, Baer, MR, Cairo, M, Copelan, E, Cutler, CS, Isola, L, Lazarus, HM, Litzow, MR, Marks, DI, Ringdén, O, Rizzieri, DA, Soiffer, R, Larson, RA, Tallman, MS, Bloomfield, CD & Weisdorf, DJ 2011, 'Comparison of reduced-intensity hematopoietic cell transplantation with chemotherapy in patients age 60-70 years with acute myelogenous leukemia in first remission', Biology of Blood and Marrow Transplantation, vol. 17, no. 12, pp. 1796-1803. https://doi.org/10.1016/j.bbmt.2011.06.005

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title = "Comparison of reduced-intensity hematopoietic cell transplantation with chemotherapy in patients age 60-70 years with acute myelogenous leukemia in first remission",

abstract = "We compared the outcomes of patients age 60-70 years with acute myelogenous leukemia receiving reduced-intensity allogeneic hematopoietic cell transplantation (HCT) in first remission (CR1) reported to the Center for International Blood and Marrow Research (n = 94) with the outcomes in patients treated with induction and postremission chemotherapy on Cancer and Leukemia Group B protocols (n = 96). All patients included had been in CR1 for at least 4 months. The HCT recipients were slightly younger than the chemotherapy patients (median age, 63 years vs 65 years; P <.001), but there were no significant between-group differences in the proportion with therapy-related leukemia or in different cytogenetic risk groups. Time from diagnosis to CR1 was longer for the HCT recipients (median, 44 days vs 38 days; P =.031). Allogeneic HCT was associated with significantly lower risk of relapse (32% vs 81% at 3 years; P <.001), higher nonrelapse mortality (36% vs 4% at 3 years; P <.001), and longer leukemia-free survival (32% vs 15% at 3 years; P =.001). Although overall survival was longer for HCT recipients, the difference was not statistically significant (37% vs 25% at 3 years; P =.08). Our findings suggest that reduced-intensity conditioning allogeneic HCT in patients age 60-70 with acute myelogenous leukemia in CR1 reduces relapse and improves leukemia-free survival. Strategies that reduce nonrelapse mortality may yield significant improvements in overall survival.",

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note = "Funding Information: Financial Disclosure : The Center for International Blood and Marrow Research is supported by Public Health Service Grant/Cooperative Agreement U24-CA76518 from the National Cancer Institute, National Heart, Lung and Blood Institute , and National Institute of Allergy and Infectious Diseases; Grant/Cooperative Agreement 5U01HL069294 from the National Heart, Lung and Blood Institute and National Cancer Institute ; Contract HHSH234200637015C from the Health Resources and Services Administration ; Grants N00014-06-1-0704 and N00014-08-1-0058 from the Office of Naval Research; and grants from AABB; Allos, Inc; Amgen, Inc ; Anonymous donation to the Medical College of Wisconsin; Astellas Pharma US, Inc; Be the Match Foundation; Biogen IDEC; BioMarin Pharmaceutical, Inc; Biovitrum AB; BloodCenter of Wisconsin; Blue Cross and Blue Shield Association; Bone Marrow Foundation; Buchanan Family Foundation; CaridianBCT; Celgene Corporation; CellGenix, GmbH; Children{\textquoteright}s Leukemia Research Association; ClinImmune Labs; CTI Clinical Trial and Consulting Services; Eisai, Inc; Genentech, Inc; Genzyme Corporation; Histogenetics, Inc; HKS Medical Information Systems; Hospira, Inc; Kirin Brewery Co, Ltd; The Leukemia and Lymphoma Society; Merck & Company; The Medical College of Wisconsin; Millennium Pharmaceuticals, Inc; Miller Pharmacal Group; Milliman USA, Inc; Miltenyi Biotec, Inc; National Marrow Donor Program; Nature Publishing Group; Novartis Oncology; Oncology Nursing Society; Osiris Therapeutics, Inc; Otsuka America Pharmaceutical, Inc; Pall Life Sciences; Pfizer Inc; Schering Corporation; Sigma-Tau Pharmaceuticals; Soligenix, Inc; StemCyte, Inc; StemSoft Software, Inc; Sysmex America, Inc; THERAKOS, Inc; Vidacare Corporation; ViraCor Laboratories; ViroPharma, Inc; and Wellpoint, Inc The views expressed in this paper do not reflect the official policy or position of the National Institutes of Health, Department of the Navy, Department of Defense, or any other agency of the U.S. Government. Funding Information: This research was supported in part by grants from the National Cancer Institute to Cancer and Leukemia Group B ( CA101140, CA31946, CA77658, CA33601, CA41287, CA47545, CA03927, CA47577, CA35279, and CA32291), NCI CA16058 , and the Coleman Leukemia Research Fund. ",

year = "2011",

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T1 - Comparison of reduced-intensity hematopoietic cell transplantation with chemotherapy in patients age 60-70 years with acute myelogenous leukemia in first remission

AU - Farag, Sherif S.

AU - Maharry, Kati

AU - Zhang, Mei Jie

AU - Pérez, Waleska S.

AU - George, Stephen L.

AU - Mrózek, Krzysztof

AU - DiPersio, John

AU - Bunjes, Donald W.

AU - Marcucci, Guido

AU - Baer, Maria R.

AU - Cairo, Mitchell

AU - Copelan, Edward

AU - Cutler, Corey S.

AU - Isola, Luis

AU - Lazarus, Hillard M.

AU - Litzow, Mark R.

AU - Marks, David I.

AU - Ringdén, Olle

AU - Rizzieri, David A.

AU - Soiffer, Robert

AU - Larson, Richard A.

AU - Tallman, Martin S.

AU - Bloomfield, Clara D.

AU - Weisdorf, Daniel J.

N1 - Funding Information: Financial Disclosure : The Center for International Blood and Marrow Research is supported by Public Health Service Grant/Cooperative Agreement U24-CA76518 from the National Cancer Institute, National Heart, Lung and Blood Institute , and National Institute of Allergy and Infectious Diseases; Grant/Cooperative Agreement 5U01HL069294 from the National Heart, Lung and Blood Institute and National Cancer Institute ; Contract HHSH234200637015C from the Health Resources and Services Administration ; Grants N00014-06-1-0704 and N00014-08-1-0058 from the Office of Naval Research; and grants from AABB; Allos, Inc; Amgen, Inc ; Anonymous donation to the Medical College of Wisconsin; Astellas Pharma US, Inc; Be the Match Foundation; Biogen IDEC; BioMarin Pharmaceutical, Inc; Biovitrum AB; BloodCenter of Wisconsin; Blue Cross and Blue Shield Association; Bone Marrow Foundation; Buchanan Family Foundation; CaridianBCT; Celgene Corporation; CellGenix, GmbH; Children’s Leukemia Research Association; ClinImmune Labs; CTI Clinical Trial and Consulting Services; Eisai, Inc; Genentech, Inc; Genzyme Corporation; Histogenetics, Inc; HKS Medical Information Systems; Hospira, Inc; Kirin Brewery Co, Ltd; The Leukemia and Lymphoma Society; Merck & Company; The Medical College of Wisconsin; Millennium Pharmaceuticals, Inc; Miller Pharmacal Group; Milliman USA, Inc; Miltenyi Biotec, Inc; National Marrow Donor Program; Nature Publishing Group; Novartis Oncology; Oncology Nursing Society; Osiris Therapeutics, Inc; Otsuka America Pharmaceutical, Inc; Pall Life Sciences; Pfizer Inc; Schering Corporation; Sigma-Tau Pharmaceuticals; Soligenix, Inc; StemCyte, Inc; StemSoft Software, Inc; Sysmex America, Inc; THERAKOS, Inc; Vidacare Corporation; ViraCor Laboratories; ViroPharma, Inc; and Wellpoint, Inc The views expressed in this paper do not reflect the official policy or position of the National Institutes of Health, Department of the Navy, Department of Defense, or any other agency of the U.S. Government. Funding Information: This research was supported in part by grants from the National Cancer Institute to Cancer and Leukemia Group B ( CA101140, CA31946, CA77658, CA33601, CA41287, CA47545, CA03927, CA47577, CA35279, and CA32291), NCI CA16058 , and the Coleman Leukemia Research Fund.

PY - 2011/12

Y1 - 2011/12

N2 - We compared the outcomes of patients age 60-70 years with acute myelogenous leukemia receiving reduced-intensity allogeneic hematopoietic cell transplantation (HCT) in first remission (CR1) reported to the Center for International Blood and Marrow Research (n = 94) with the outcomes in patients treated with induction and postremission chemotherapy on Cancer and Leukemia Group B protocols (n = 96). All patients included had been in CR1 for at least 4 months. The HCT recipients were slightly younger than the chemotherapy patients (median age, 63 years vs 65 years; P <.001), but there were no significant between-group differences in the proportion with therapy-related leukemia or in different cytogenetic risk groups. Time from diagnosis to CR1 was longer for the HCT recipients (median, 44 days vs 38 days; P =.031). Allogeneic HCT was associated with significantly lower risk of relapse (32% vs 81% at 3 years; P <.001), higher nonrelapse mortality (36% vs 4% at 3 years; P <.001), and longer leukemia-free survival (32% vs 15% at 3 years; P =.001). Although overall survival was longer for HCT recipients, the difference was not statistically significant (37% vs 25% at 3 years; P =.08). Our findings suggest that reduced-intensity conditioning allogeneic HCT in patients age 60-70 with acute myelogenous leukemia in CR1 reduces relapse and improves leukemia-free survival. Strategies that reduce nonrelapse mortality may yield significant improvements in overall survival.

AB - We compared the outcomes of patients age 60-70 years with acute myelogenous leukemia receiving reduced-intensity allogeneic hematopoietic cell transplantation (HCT) in first remission (CR1) reported to the Center for International Blood and Marrow Research (n = 94) with the outcomes in patients treated with induction and postremission chemotherapy on Cancer and Leukemia Group B protocols (n = 96). All patients included had been in CR1 for at least 4 months. The HCT recipients were slightly younger than the chemotherapy patients (median age, 63 years vs 65 years; P <.001), but there were no significant between-group differences in the proportion with therapy-related leukemia or in different cytogenetic risk groups. Time from diagnosis to CR1 was longer for the HCT recipients (median, 44 days vs 38 days; P =.031). Allogeneic HCT was associated with significantly lower risk of relapse (32% vs 81% at 3 years; P <.001), higher nonrelapse mortality (36% vs 4% at 3 years; P <.001), and longer leukemia-free survival (32% vs 15% at 3 years; P =.001). Although overall survival was longer for HCT recipients, the difference was not statistically significant (37% vs 25% at 3 years; P =.08). Our findings suggest that reduced-intensity conditioning allogeneic HCT in patients age 60-70 with acute myelogenous leukemia in CR1 reduces relapse and improves leukemia-free survival. Strategies that reduce nonrelapse mortality may yield significant improvements in overall survival.

KW - Acute myeloid leukemia

KW - Allogeneic

KW - Chemotherapy

KW - Reduced-intensity

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Comparison of reduced-intensity hematopoietic cell transplantation with chemotherapy in patients age 60-70 years with acute myelogenous leukemia in first remission

Abstract

Bibliographical note

Keywords

UN SDGs

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