Abstract:
:Therapy-related acute myeloid leukemia (t-AML) arises as a late complication following antecedent solid tumors or hematologic diseases and their associated treatments. There are limited data regarding risk factors and outcomes following allogeneic hematopoietic cell transplantation (HCT) for t-AML following a prior solid tumor, and furthermore, the impact of myeloablative (MAC) vs reduced-intensity conditioning (RIC) on survival is unknown. The acute leukemia working party (ALWP) of the European society for blood and bone marrow transplantation (EBMT) performed a large registry study that included 535 patients with t-AML and prior solid tumor who underwent first MAC or RIC allogeneic HCT from 2000-2016. The primary endpoints of the study were OS and LFS. Patients receiving RIC regimens had an increase in relapse incidence (hazard ratio [HR], 1.52; 95% confidence interval [CI] 1.02-2.26; P = 0.04), lower LFS (HR, 1.52; 95% CI 1.12-2.05, P = 0.007), and OS (HR, 1.51; CI 1.09-2.09; P = 0.012). There were no differences in NRM and GRFS. Importantly, LFS and OS were superior in patients receiving ablative regimens due to a decrease in relapse. As NRM continues to decline in the current era, it is conceivable that outcomes of HCT for t-AML with prior solid tumor may be improved by careful patient selection for myeloablative regimens.
journal_name
Am J Hematoljournal_title
American journal of hematologyauthors
Lee CJ,Labopin M,Beelen D,Finke J,Blaise D,Ganser A,Itälä-Remes M,Chevallier P,Labussière-Wallet H,Maertens J,Yakoub-Agha I,Bourhis JH,Mailhol A,Mohty M,Savani BN,Nagler Adoi
10.1002/ajh.25395subject
Has Abstractpub_date
2019-04-01 00:00:00pages
431-438issue
4eissn
0361-8609issn
1096-8652journal_volume
94pub_type
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