TY - JOUR
T1 - Cytogenetic risk determines outcomes after allogeneic transplantation in older patients with acute myeloid leukemia in their second complete remission
T2 - A Center for International Blood and Marrow Transplant Research cohort analysis
AU - Michelis, Fotios V.
AU - Gupta, Vikas
AU - Zhang, Mei Jie
AU - Wang, Hai Lin
AU - Aljurf, Mahmoud
AU - Bacher, Ulrike
AU - Beitinjaneh, Amer
AU - Chen, Yi Bin
AU - DeFilipp, Zachariah
AU - Gale, Robert Peter
AU - Kebriaei, Partow
AU - Kharfan-Dabaja, Mohamed
AU - Lazarus, Hillard M.
AU - Nishihori, Taiga
AU - Olsson, Richard F.
AU - Oran, Betul
AU - Rashidi, Armin
AU - Rizzieri, David A.
AU - Tallman, Martin S.
AU - de Lima, Marcos
AU - Khoury, H. Jean
AU - Sandmaier, Brenda M.
AU - Weisdorf, Daniel
AU - Saber, Wael
AU - for the Acute Leukemia Working Committee of the Center for International Blood and Marrow Transplant Research, aresearch collaboration between the National Marrow Donor Program/Be the Match Registry and theMedicalCollegeofWisconsin
N1 - Publisher Copyright:
© 2017 American Cancer Society
PY - 2017/6/1
Y1 - 2017/6/1
N2 - BACKGROUND: Allogeneic hematopoietic cell transplantation (HCT) offers curative potential to a number of older patients with acute myeloid leukemia (AML) in their first complete remission. However, there are limited data in the literature concerning post-HCT outcomes for older patients in their second complete remission (CR2). METHODS: The purpose of the current study was to retrospectively investigate within the Center for International Blood and Marrow Transplant Research database parameters influencing posttransplant outcomes for patients 60 years of age or older undergoing HCT for AML in CR2. RESULTS: In total, 196 patients from 78 centers were identified; the median age was 64 years (range, 60-78 years). Seventy-one percent had a Karnofsky performance status ≥ 90 at the time of HCT. Reduced-intensity conditioning regimens were used in 159 patients (81%). A univariate analysis demonstrated a 3-year overall survival (OS) rate of 42% (95% confidence interval [CI], 35%-49%), a leukemia-free survival rate of 37% (95% CI, 30%-44%), a cumulative incidence of nonrelapse mortality of 25% (95% CI, 19%-32%), and a cumulative incidence of relapse (CIR) of 38% (95% CI, 31%-45%). A multivariate analysis demonstrated that cytogenetic risk was the only independent risk factor for OS (P =.023) with a hazard ratio (HR) of 1.14 (95% CI, 0.59-2.19) for intermediate-risk cytogenetics and an HR of 2.32 (95% CI, 1.05-5.14) for unfavorable-risk cytogenetics. For CIR, cytogenetic risk was also the only independent prognostic factor (P =.01) with an HR of 1.10 (95% CI, 0.47-2.56) for intermediate-risk cytogenetics and an HR of 2.98 (95% CI, 1.11-8.00) for unfavorable-risk cytogenetics. CONCLUSIONS: Allogeneic HCT is a curative treatment option for older patients with AML in CR2, particularly for those with favorable or intermediate cytogenetic risk. Cancer 2017;123:2035–2042.
AB - BACKGROUND: Allogeneic hematopoietic cell transplantation (HCT) offers curative potential to a number of older patients with acute myeloid leukemia (AML) in their first complete remission. However, there are limited data in the literature concerning post-HCT outcomes for older patients in their second complete remission (CR2). METHODS: The purpose of the current study was to retrospectively investigate within the Center for International Blood and Marrow Transplant Research database parameters influencing posttransplant outcomes for patients 60 years of age or older undergoing HCT for AML in CR2. RESULTS: In total, 196 patients from 78 centers were identified; the median age was 64 years (range, 60-78 years). Seventy-one percent had a Karnofsky performance status ≥ 90 at the time of HCT. Reduced-intensity conditioning regimens were used in 159 patients (81%). A univariate analysis demonstrated a 3-year overall survival (OS) rate of 42% (95% confidence interval [CI], 35%-49%), a leukemia-free survival rate of 37% (95% CI, 30%-44%), a cumulative incidence of nonrelapse mortality of 25% (95% CI, 19%-32%), and a cumulative incidence of relapse (CIR) of 38% (95% CI, 31%-45%). A multivariate analysis demonstrated that cytogenetic risk was the only independent risk factor for OS (P =.023) with a hazard ratio (HR) of 1.14 (95% CI, 0.59-2.19) for intermediate-risk cytogenetics and an HR of 2.32 (95% CI, 1.05-5.14) for unfavorable-risk cytogenetics. For CIR, cytogenetic risk was also the only independent prognostic factor (P =.01) with an HR of 1.10 (95% CI, 0.47-2.56) for intermediate-risk cytogenetics and an HR of 2.98 (95% CI, 1.11-8.00) for unfavorable-risk cytogenetics. CONCLUSIONS: Allogeneic HCT is a curative treatment option for older patients with AML in CR2, particularly for those with favorable or intermediate cytogenetic risk. Cancer 2017;123:2035–2042.
KW - Center for International Blood and Marrow Transplant Research (CIBMTR)
KW - acute myeloid leukemia (AML)
KW - allogeneic transplant
KW - elderly
KW - second complete remission
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U2 - 10.1002/cncr.30567
DO - 10.1002/cncr.30567
M3 - Article
C2 - 28117898
AN - SCOPUS:85019946749
SN - 0008-543X
VL - 123
SP - 2035
EP - 2042
JO - Cancer
JF - Cancer
IS - 11
ER -
