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Impact of cytogenetics on outcome of matched unrelated donor hematopoietic stem cell transplantation for acute myeloid leukemia in first or second complete remission. Blood 2007 Jul 01;110(1):409-17 PMID: 17374741 PMCID: PMC1896123

Pubmed ID

17374741

Abstract

We compared the treatment-related mortality, relapse rate, disease-free survival (DFS), and overall survival (OS) by cytogenetic risk group of 261 patients with acute myeloid leukemia in first complete remission (CR1) and 299 patients in CR2 in undergoing matched unrelated donor hematopoietic stem cell transplantation (HSCT). For patients in first CR, the DFS and OS at 5 years were similar for the favorable, intermediate, and unfavorable risk groups at 29% (95% confidence interval [CI], 8%-56%) and 30% (22%-38%); 27% (19%-39%) and 29% (8%-56%); and 30% (95% CI, 22%-38%) and 30% (95% CI, 20%-41%), respectively. For patients in second CR, the DFS and OS at 5 years were 42% (95% CI, 33%-52%) and 35% (95% CI, 28%-43%); 38% (95% CI, 23%-54%) and 45% (95% CI, 35%-55%); and 37% (95% CI, 30%-45%) and 36% (95% CI, 21%-53%), respectively. Cytogenetics had little influence on the overall outcome for patients in first CR. In second CR, outcome was modestly, but not significantly, better for patients with favorable cytogenetics. The graft-versus-leukemia effect appeared effective, even in patients with unfavorable cytogenetics. However, treatment-related mortality was high. Matched unrelated donor HSCT should be considered for all patients with unfavorable cytogenetics who lack a suitable HLA-matched sibling donor.

Author List

Tallman MS, Dewald GW, Gandham S, Logan BR, Keating A, Lazarus HM, Litzow MR, Mehta J, Pedersen T, Pérez WS, Rowe JM, Wetzler M, Weisdorf DJ

Author

Brent R. Logan PhD Director, Professor in the Institute for Health and Equity department at Medical College of Wisconsin

Scopus

2-s2.0-34347391058   57 Citations

MESH terms used to index this publication - Major topics in bold

Acute Disease
Adolescent
Adult
Bone Marrow Transplantation
Child
Child, Preschool
Chromosome Aberrations
Cytogenetics
Hematopoietic Stem Cell Transplantation
Histocompatibility
Humans
Leukemia, Myeloid
Middle Aged
Remission Induction
Survival Analysis
Tissue Donors
Treatment Outcome