Longitudinal Outcome over Two Decades of Unrelated Allogeneic Stem Cell Transplantation for Relapsed/ Refractory Acute Myeloid Leukemia: An ALWP/EBMT Analysis

Nagler A, Ngoya M, Galimard JE, Labopin M, Bornhaeuser M, Stelljes M, Finke J, Ganser A, Einsele H, Kroeger N, Brecht A, Bethge W, Edinger M, Kulagin A, Passweg J, Blau IW, Elmaagacli A, Schaefer-Eckart K, Platzbecker U, Schroeder T, Bunjes D, Tischer J, Martin S, Spyridonidis A, Giebel S, Savani B, Mohty M (2022)

Publication Type: Journal article

Publication year: 2022

Journal

Book Volume: 28

Pages Range: 4258-4266

Journal Issue: 19

DOI: 10.1158/1078-0432.CCR-22-0809

Abstract

Purpose: We evaluated outcomes of unrelated transplantation for primary refractory/relapsed (ref/rel) acute myeloid leukemia (AML), comparing two cohorts according to the year of transplant, 2000-2009 and 2010-2019. Patients and Methods: Multivariable analyses were performed using the Cox proportional-hazards regression model. Results: 3,430 patients were included; 876 underwent a transplant between 2000-2009 and 2554 in 2010-2019. Median followup was 8.7 (95% CI, 7.8-9.4) and 3.4 (95% CI, 3.1-3.6) years (P < 0.001). Median age was 52 (18-77) and 56 (18-79) years (P > 0.0001); 45.5% and 55.5% had refractory AML while 54.5% and 44.5% had relapsed AML. Conditioning was myeloablative in 60% and 52%, respectively. Neutrophil recovery and day 100 incidence of acute and 2-year incidence of chronic graft-versus-host disease (GvHD) were similar between the two periods. Two-year relapse incidence was higher for patients undergoing transplant in the 2000-2009 period versus those undergoing transplant in 2010- 2019: 50.2% versus 45.1% (HR, 0.85; 95% CI, 0.74-0.97; P=0. 002). Leukemia-free survival; overall survival; and GvHD-free, relapsefree survival were lower for the 2000-2009 period: 26% versus 32.1% (HR, 0.87; 95% CI, 0.78-0.97; P = 0.01), 32.1% versus 38.1% (HR, 0.86; 95% CI, 0.77-0.96; P = 0.01), and 21.5% versus 25.3% (HR, 0.89; 95% CI, 0.81-0.99; P = 0.03), respectively. Two-year nonrelapse mortality was not significantly different (23.8% vs. 23.7%; HR, 0.91; 95% CI, 0.76-1.11; P = 0.34). Conclusions: Outcome of unrelated transplantation for patients with ref/rel AML has improved in the last two decades, rescuing about one third of the patients.

Involved external institutions

Chaim Sheba Medical Center at Tel HaShomer / המרכז הרפואי עש חיים שיבא – תל השומר‎‎ Israel (IL) European Society for Blood and Marrow Transplantation EBMT Netherlands (NL) University of Paris 4 - Paris-Sorbonne / Université paris IV Paris-Sorbonne France (FR) Universitätsklinikum Carl Gustav Carus Dresden Germany (DE) Westfälische Wilhelms-Universität (WWU) Münster Germany (DE) Albert-Ludwigs-Universität Freiburg Germany (DE) Medizinische Hochschule Hannover (MHH) / Hannover Medical School Germany (DE) Universitätsklinikum Würzburg Germany (DE) Universitätsklinikum Hamburg-Eppendorf (UKE) Germany (DE) Deutsche Klinik für Diagnostik (DKD) Germany (DE) Eberhard Karls Universität Tübingen Germany (DE) Universität Regensburg Germany (DE) First Pavlov State Medical University of St. Petersburg Russian Federation (RU) Universitätsspital Basel Switzerland (CH) Charité - Universitätsmedizin Berlin Germany (DE) Asklepios Kliniken Germany (DE) Klinikum Nürnberg Germany (DE) Universitätsklinikum Leipzig Germany (DE) Universitätsklinikum Essen Germany (DE) Universitätsklinikum Ulm Germany (DE) Klinikum der Universität München (Großhadern und Innenstadt) Germany (DE) Robert-Bosch-Krankenhaus Germany (DE) Universitätsklinikum Patras Greece (GR) Maria Skłodowska-Curie Institute of Oncology / Centrum Onkologii–Instytut im. Marii Skłodowskiej-Curie w Warszawie Poland (PL) Vanderbilt University United States (USA) (US)

How to cite

APA:

Nagler, A., Ngoya, M., Galimard, J.-E., Labopin, M., Bornhaeuser, M., Stelljes, M.,... Mohty, M. (2022). Longitudinal Outcome over Two Decades of Unrelated Allogeneic Stem Cell Transplantation for Relapsed/ Refractory Acute Myeloid Leukemia: An ALWP/EBMT Analysis. Clinical Cancer Research, 28(19), 4258-4266. https://doi.org/10.1158/1078-0432.CCR-22-0809

MLA:

Nagler, Arnon, et al. "Longitudinal Outcome over Two Decades of Unrelated Allogeneic Stem Cell Transplantation for Relapsed/ Refractory Acute Myeloid Leukemia: An ALWP/EBMT Analysis." Clinical Cancer Research 28.19 (2022): 4258-4266.

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