Outcomes of allogeneic stem cell transplantation among patients with acute myeloid leukemia presenting active disease: Experience of a single European Comprehensive Cancer Center

Rev Assoc Med Bras (1992). 2016 Oct;62(7):641-646. doi: 10.1590/1806-9282.62.07.641.

Abstract

Introduction:: Allogeneic hematopoietic stem cell transplantation (ASCT) representes a potentially curative approach for patients with relapsed or refractory acute myeloid leukemia (AML). We report the outcome of relapsed/refractory AML patients treated with ASCT.

Method:: A retrospective cohort from 1994 to 2013 that included 61 patients with diagnosis of relapsed/refractory AML. Outcomes of interest were transplant-related mortality (TRM), incidence of acute and chronic graft-versus-host disease (GVHD), relapse incidence, progression-free survival (PFS) and overall survival (OS). Statistical significance was set at p<0.05.

Results:: The median age was 61 years (range 1 to 65). The cumulative incidence of 90 days, 1 year, and 3 years TRM were 60%, 26.7%, and 13.3%, respectively (p<0.001). The incidence of relapse was 21.7% at 1 year, 13% at 3 years, and 8.7% at 5 years. Median OS was estimated to be 8 months (95CI 3.266-12.734) and median PFS, 3 months (95CI 1.835-4.165).

Conclusion:: In our cohort, TRM in first years after ASCT remains considerable, but ASCT in this setting seems to be a good choice for AML patients with active disease. However, novel approaches are needed to reduce TRM and relapse in this set of patients.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Child, Preschool
  • Chronic Disease
  • Disease Progression
  • Disease-Free Survival
  • Endpoint Determination
  • Female
  • Graft vs Host Disease
  • Hematopoietic Stem Cell Transplantation / methods*
  • Hematopoietic Stem Cell Transplantation / mortality*
  • Humans
  • Infant
  • Kaplan-Meier Estimate
  • Leukemia, Myeloid, Acute / mortality*
  • Leukemia, Myeloid, Acute / surgery*
  • Male
  • Middle Aged
  • Recurrence
  • Retrospective Studies
  • Statistics, Nonparametric
  • Time Factors
  • Transplantation, Homologous / methods
  • Transplantation, Homologous / mortality
  • Treatment Outcome
  • Young Adult