Unrelated donor versus matched sibling donor in adults with acute myeloid leukemia in first relapse: an ALWP-EBMT study
In: Journal of Hematology and Oncology Journal of Hematology and Oncology, BioMed Central, 2016, 9, pp.89. ⟨10.1186/s13045-016-0321-y⟩, Jg. 9 (2016), Heft 1, S. 1-8
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Zugriff:
International audience; Background: Allogeneic stem cell transplantation is the only curative option for patients with acute myeloid leukemia (AML) experiencing relapse. Either matched sibling donor (MSD) or unrelated donor (UD) is indicated.Methods: We analyzed 1554 adults with AML transplanted from MSD (n = 961) or UD (n = 593, HLA-matched 10/10, n = 481; 9/10, n = 112). Compared to MSD, UD recipients were older (49 vs 52 years, p = 0.001), transplanted more recently (2009 vs 2006, p = 0.001), and with a longer interval to transplant (10 vs 9 months, p = 0.001). Conditioning regimen was more frequently myeloablative for patients transplanted with a MSD (61 vs 46 %, p = 0.001). Median follow-up was 28 (range 3–157) months.Results: Cumulative incidence (CI) of neutrophil engraftment (p = 0.07), grades II–IV acute GVHD (p = 0.11), chronic GVHD (p = 0.9), and non-relapse mortality (NRM, p = 0.24) was not different according to the type of donor. At 2 years, CI of relapse (relapse incidence (RI)) was 57 vs 49 % (p = 0.001). Leukemia-free survival (LFS) at 2 years was 21 vs 26 % (p = 0.001), and overall survival (OS) was 26 vs 33 % (p = 0.004) for MSD vs UD, respectively. Chronic GVHD as time-dependent variable was associated with lower RI (HR 0.78, p = 0.05), higher NRM (HR 1.71, p = 0.001), and higher OS (HR 0.69, p = 0.001). According to HLA match, RI was 57 vs 50 vs 45 %, (p = 0.001) NRM was 23 vs 23 vs 29 % (p = 0.26), and LFS at 2 years was 21 vs 27 vs 25 % (p = 0.003) for MSD, 10/10, and 9/10 UD, respectively. In multivariate analysis adjusted for differences between the two groups, UD was associated with lower RI (HR 0.76, p = 0.001) and higher LFS (HR 0.83, p = 0.001) compared to MSD. Interval between diagnosis and transplant was the other factor associated with better outcomes (RI (HR 0.62, p
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Unrelated donor versus matched sibling donor in adults with acute myeloid leukemia in first relapse: an ALWP-EBMT study
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| Autor/in / Beteiligte Person: | Stelljes, Matthias ; Labopin, Myriam ; Ehninger, Gerhard ; Tischer, Johanna ; Jindra, Pavel ; Kröger, Nicolaus ; Ganser, Arnold ; Ruggeri, Annalisa ; Beelen, Dietrich W. ; Nagler, Arnon ; Glass, Bertram ; Mohty, Mohamad ; Schwerdtfeger, Rainer ; Michallet, Mauricette ; Battipaglia, Giorgia ; Arnold, Renate ; Finke, Jürgen ; Service d'hématologie clinique et de thérapie cellulaire [CHU Saint-Antoine] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU) ; Università degli studi di Napoli Federico, II ; Technische Universität Dresden = Dresden University of Technology (TU Dresden) ; University Hospital Essen ; Ludwig-Maximilians University [Munich] (LMU) ; Hannover Medical School [Hannover] (MHH) ; Berlin-Buch, Helios-Klinikum ; Asklepios Klinik St. Georg Hamburg ; University Medical Centre Freiburg ; Hematology Laboratory, Hospices Civils de Lyon ; Westfälische Wilhelms-Universität Münster (WWU) ; Charles University Hospital ; Charité - UniversitätsMedizin = Charité - University Hospital [Berlin] ; Universitaetsklinikum Hamburg-Eppendorf = University Medical Center Hamburg-Eppendorf [Hamburg] (UKE) ; Centre de Recherche Saint-Antoine (UMRS893) ; Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM) ; Université Pierre et Marie Curie - Paris 6 (UPMC) ; Chaim Sheba Medical Center ; CHU Saint-Antoine [AP-HP] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU) ; HAL UPMC, Gestionnaire ; University of Naples Federico II = Università degli studi di Napoli Federico, II ; Ludwig-Maximilians-Universität München (LMU) ; Westfälische Wilhelms-Universität Münster = University of Münster (WWU) ; Ruggeri, A. ; Battipaglia, G. ; Labopin, M. ; Ehninger, G. ; Beelen, D. ; Tischer, J. ; Ganser, A. ; Schwerdtfeger, R. ; Glass, B. ; Finke, J. ; Michallet, M. ; Stelljes, M. ; Jindra, P. ; Arnold, R. ; Kroger, N. ; Mohty, M. ; Nagler, A. |
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| Zeitschrift: | Journal of Hematology and Oncology Journal of Hematology and Oncology, BioMed Central, 2016, 9, pp.89. ⟨10.1186/s13045-016-0321-y⟩, Jg. 9 (2016), Heft 1, S. 1-8 |
| Veröffentlichung: | HAL CCSD, 2016 |
| Medientyp: | unknown |
| ISSN: | 1756-8722 (print) |
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