Logo image
Back
Prognostic factors of long-term survival in patients with acute myeloid leukemia after allogeneic or autologous stem cell transplantation
Abstract   Peer reviewed

Prognostic factors of long-term survival in patients with acute myeloid leukemia after allogeneic or autologous stem cell transplantation

L. Wang, C. Corona, X. Nie, L. Mejias, S. j. Hou, R. Mullaney, K. M. Ward, D. L. Topolsky, M. Styler and P. A. Crilley
Journal of clinical oncology, v 29(15_suppl), pp 6594-6594
20 May 2011
DOI: https://doi.org/10.1200/jco.2011.29.15_suppl.6594

Abstract

Background: The purpose of this study is to provide a long-term survival analysis for patients with acute myeloid leukemia (AML) after allogeneic or autologous stem cell transplantation (SCT). Methods: The patients included were 210 AML patients treated at Hahnemann University Hospital from 1980 through 2004. End points were overall survival (OS) and progression-free survival (PFS) calculated by Kaplan-Meier method. Results: We showed a statistically significant long-term survival advantage when transplantation was performed in the first complete remission (CR1) as opposed to subsequent remissions or relapse (median OS: 97 months vs 17 months vs 3 months for allogeneic SCT, and 38 months vs 13 months vs 4 months for autologous SCT, p<0.001). Compared to autologous SCT, there was a 60% improvement in median OS for patients treated with allogeneic SCT in CR1 (p=0.025). Among AML subtypes, a trend toward improved survival was noted for M2 following allogeneic, but not autologous, SCT. The median OS was not reached for M2 after 20 years follow-up (P<0.08). Although severe graft versus host disease (GVHD) was associated with early transplant-related mortality, occurrence of grade I and II acute or limited chronic GVHD had favorable long-term survival. On the contrary, veno-occlusive disease (VOD) of the liver had little impact on long-term survival. We also compared outcomes of overall survival for patients who received different pre-transplant conditioning regimens after allogeneic SCT. Compared to BU/CY4 (busulfan 16mg/kg plus cyclophosphamide 200mg/kg given over 4 days) and BU/CY/VP (busulfan 16mg/kg, cyclophosphamide 120mg/kg, VP16 40mg/kg), BU/CY2 (busulfan 16mg/kg plus cyclophosphamide 120mg/kg given over 2 days) was associated with a significantly improved long-term survival (59.6% vs 27.3% vs 15.5% at 10 years, P< 0.001). Conclusions: These results demonstrated a superior overall survival in AML patients who received allogeneic SCT in CR1 compared to autologous SCT at the same remission status. AML subclasses, pre-transplant conditioning regimens, and grade I/II GVHD are additional factors contributing to long-term survival after allogeneic SCT.

Metrics

6 Record Views

Details

InCites Highlights

Data related to this publication, from InCites Benchmarking & Analytics tool:

Web of Science research areas
Oncology
Logo image