Effect of allogeneic hematopoietic stem cell transplantation from matched siblings or unrelated donors during the first complete remission in patients with cytogenetically normal acute myeloid leukemia

2011 ◽  
Vol 86 (3) ◽  
pp. 237-245 ◽  
Author(s):  
Yao-Yu Hsieh ◽  
Ying-Chung Hong ◽  
Liang-Tsai Hsiao ◽  
Yuan-Bin Yu ◽  
Jin-Hwang Liu ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Complete Remission ◽  
Stem Cell Transplantation ◽  
Myeloid Leukemia ◽  
Hematopoietic Stem ◽  
Unrelated Donors ◽  
First Complete Remission ◽  
Acute Myeloid

Superiority of Haploidentical Related Hematopoietic Stem-Cell Transplantation Over Chemotherapy Alone for Patients with Intermediate- or Poor- Risk Acute Myeloid Leukemia in First Complete Remission,

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 4161-4161
Author(s):  
Yingjun Chang ◽  
Honghu Zhu ◽  
Lanping Xu ◽  
Hao Jiang ◽  
Daihong Liu ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Complete Remission ◽  
Stem Cell Transplantation ◽  
Myeloid Leukemia ◽  
Hematopoietic Stem ◽  
Poor Risk ◽  
First Complete Remission ◽  
Acute Myeloid

Abstract Abstract 4161 Purpose: The role of HLA-haploidentical related donors (HRD) hematopoietic stem-cell transplantation (HSCT) in first complete remission (CR1) for adults with intermediate and poor risk acute myeloid leukemia (AML) is still not clear. Patients and Methods: Totally 428 newly diagnosed AML patients between 15 and 60 years old were studied between Jan 2006 and May 2010. Among 240 patients with intermediate and poor risk cytogenetics, 191patients achieved CR1 and received chemotherapy alone or HSCT as post-remission treatment. Of these, 141 patients received chemotherapy alone (n=78) or HRD HSCT (n=63) were analyzed. Results: Up to last follow-up time of May 2011, 44 out of 141 patients died (36 died of relapse and 8 died of TRM) and 97 patients are still alive. 49 out of 141 patients experienced relapse and 84 patients are still in continuous CR1. The cumulative incidence of relapse (CIR) at 4 years was 37.4%±4.4%. Overall survival(OS) and disease-free survival(DFS) at 4 year was 63.8%±5.0% and 55.5%±4.9%, respectively. The CIR of HRD HSCT group was significantly lower than chemotherapy group(12.8%±6.1% vs.57.4%±5.6%, p<0.0001). HRD HSCT improved survival achieved by chemotherapy alone significantly (DFS at 4 years, 71.8%±6.9% v 42.6%±6.1%, p<0.0001;OS at 4 years,75.7% ±7.0% v 54.6%±6.1%, p=0.0014). Univariate and multivariate analysis showed post-remission treatment choice (HRD HSCT or chemotherapy) and high WBC at diagnosis were independent risk factor affecting relapse, DFS and OS. Conclusion: HRD HSCT in CR1 is superior to chemotherapy alone for adults with intermediate and poor risk AML patients. Disclosures: No relevant conflicts of interest to declare.

Conditioning with 8-Gy total body irradiation and fludarabine for allogeneic hematopoietic stem cell transplantation in acute myeloid leukemia

Blood ◽  
2005 ◽  
Vol 106 (9) ◽  
pp. 3314-3321 ◽  
Author(s):  
Matthias Stelljes ◽  
Martin Bornhauser ◽  
Matthias Kroger ◽  
Joerg Beyer ◽  
Maria C. Sauerland ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Total Body Irradiation ◽  
Myeloid Leukemia ◽  
Hematopoietic Stem ◽  
Unrelated Donors ◽  
Total Body ◽  
Acute Myeloid

AbstractSeventy-one patients with acute myeloid leukemia (AML), most of them (63/71) considered ineligible for conventional allogeneic hematopoietic stem cell transplantation (HSCT), were enrolled into a phase 2 study on reduced-intensity myeloablative conditioning with fractionated 8-Gy total body irradiation (TBI) and fludarabine (120 mg/m2). Patients received mobilized peripheral blood stem cells (n = 68) or bone marrow (n = 3) from siblings (n = 39) or unrelated donors (n = 32). Thirty-six patients received a transplant in complete remission (CR) and 35 had untreated or refractory disease (non-CR). Median patient age was 51 years (range, 20-66 years). Sustained engraftment was attained in all evaluable patients. With a median follow-up of 25.9 months (range, 3.7-61.2 months) in surviving patients, probabilities of overall survival for patients who received a transplant in CR and non-CR were 81% and 21% at 2 years, respectively. Relapse-free survival rates were 78% and 16%. The cumulative incidence of nonrelapse mortality (NRM) in CR patients was 8% at 2 years and beyond but amounted to 37% at 2 years in non-CR patients. Outcome data in this poor-risk population indicate that allogeneic HSCT from related or unrelated donors with 8-Gy TBI/fludarabine conditioning is feasible with low NRM and preserved antileukemic activity in AML patients in first or later CR.

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