UNLABELLED: Background Allogeneic hematopoietic cell transplantation is considered the preferred post-remission therapy in patients with acute myeloid leukemia cytogenetically defined as being at high risk. To substantiate evidence for allogeneic hematopoietic cell transplantation in first complete remission in these high-risk patients we performed a landmark analysis within a single prospective multicenter treatment trial. DESIGN AND METHODS: By the time of analysis, 2,347 patients had been accrued into the AMLCG 99 trial between 1999 - 2007. Out of this population, 243 patients under 60 years old fulfilled the criteria for high-risk cytogenetics. Landmark analyses were performed with a control cohort, who remained in first complete remission at least the median time from complete remission to transplantation in the intervention group. RESULTS: After standardized induction therapy, 111 patients under 60 years old achievedcomplete remission. A matched allogeneic donor was identified for 59 patients (30 sibling donors, 29 unrelated donors). Fifty-five patients received an allogeneic hematopoietic cell transplant after a median time of 88 days in first complete remission. Of the remaining 56 patients, 21 relapsed within 90 days after achieving first complete remission and for 7 patients with relevant comorbidities no donors search was initiated, leaving 28 patients given conventional post-remission therapy as the control cohort. The median follow-up of surviving patients was 60.4 months. Patients with an allogeneic donor had substantially better 5-year overall and relapse-free survival rates than the control group (48% versus 18%, P=0.004 and 39% versus 10%, P<0.001, respectively). A survival benefit from transplantation was evident regardless of donor type, age and monosomal karyotype. Conclusions Beyond evidence available for subgroups of high-risk patients, the findings of this study establish in a broader manner that allogeneic hematopoietic cell transplantation is a preferable consolidation treatment for patients with acute myeloid leukemia and high-risk cytogenetics. The study was registered at Clinicaltrials.gov as NCT00266136.
RCT Entities:
UNLABELLED: Background Allogeneic hematopoietic cell transplantation is considered the preferred post-remission therapy in patients with acute myeloid leukemia cytogenetically defined as being at high risk. To substantiate evidence for allogeneic hematopoietic cell transplantation in first complete remission in these high-risk patients we performed a landmark analysis within a single prospective multicenter treatment trial. DESIGN AND METHODS: By the time of analysis, 2,347 patients had been accrued into the AMLCG 99 trial between 1999 - 2007. Out of this population, 243 patients under 60 years old fulfilled the criteria for high-risk cytogenetics. Landmark analyses were performed with a control cohort, who remained in first complete remission at least the median time from complete remission to transplantation in the intervention group. RESULTS: After standardized induction therapy, 111 patients under 60 years old achieved complete remission. A matched allogeneic donor was identified for 59 patients (30 sibling donors, 29 unrelated donors). Fifty-five patients received an allogeneic hematopoietic cell transplant after a median time of 88 days in first complete remission. Of the remaining 56 patients, 21 relapsed within 90 days after achieving first complete remission and for 7 patients with relevant comorbidities no donors search was initiated, leaving 28 patients given conventional post-remission therapy as the control cohort. The median follow-up of surviving patients was 60.4 months. Patients with an allogeneic donor had substantially better 5-year overall and relapse-free survival rates than the control group (48% versus 18%, P=0.004 and 39% versus 10%, P<0.001, respectively). A survival benefit from transplantation was evident regardless of donor type, age and monosomal karyotype. Conclusions Beyond evidence available for subgroups of high-risk patients, the findings of this study establish in a broader manner that allogeneic hematopoietic cell transplantation is a preferable consolidation treatment for patients with acute myeloid leukemia and high-risk cytogenetics. The study was registered at Clinicaltrials.gov as NCT00266136.
Authors: Christoph Schmid; Michael Schleuning; Georg Ledderose; Johanna Tischer; Hans-Jochem Kolb Journal: J Clin Oncol Date: 2005-08-20 Impact factor: 44.544
Authors: Thomas Büchner; Wolfgang E Berdel; Claudia Schoch; Torsten Haferlach; Hubert L Serve; Joachim Kienast; Susanne Schnittger; Wolfgang Kern; Joelle Tchinda; Albrecht Reichle; Eva Lengfelder; Peter Staib; Wolf-Dieter Ludwig; Carlo Aul; Hartmut Eimermacher; Leopold Balleisen; Maria-Cristina Sauerland; Achim Heinecke; Bernhard Wörmann; Wolfgang Hiddemann Journal: J Clin Oncol Date: 2006-06-01 Impact factor: 44.544
Authors: Jan J Cornelissen; Wim L J van Putten; Leo F Verdonck; Matthias Theobald; Emanuel Jacky; Simon M G Daenen; Marinus van Marwijk Kooy; Pierre Wijermans; Harry Schouten; Peter C Huijgens; Hans van der Lelie; Martin Fey; Augustin Ferrant; Johan Maertens; Alois Gratwohl; Bob Lowenberg Journal: Blood Date: 2007-01-09 Impact factor: 22.113
Authors: Matthias Stelljes; Martin Bornhauser; Matthias Kroger; Joerg Beyer; Maria C Sauerland; Achim Heinecke; Bjorna Berning; Christian Scheffold; Gerda Silling; Thomas Buchner; Andreas Neubauer; Axel A Fauser; Gerhard Ehninger; Wolfgang E Berdel; Joachim Kienast Journal: Blood Date: 2005-07-14 Impact factor: 22.113
Authors: U Platzbecker; C Thiede; M Füssel; G Geissler; T Illmer; B Mohr; M Hänel; R Mahlberg; U Krümpelmann; F Weissinger; M Schaich; C Theuser; G Ehninger; M Bornhäuser Journal: Leukemia Date: 2006-04 Impact factor: 11.528
Authors: D Grimwade; H Walker; F Oliver; K Wheatley; C Harrison; G Harrison; J Rees; I Hann; R Stevens; A Burnett; A Goldstone Journal: Blood Date: 1998-10-01 Impact factor: 22.113
Authors: Andrew Kent; Sumithira Vasu; Derek Schatz; Natalie Monson; Steven Devine; Clayton Smith; Jonathan A Gutman; Daniel A Pollyea Journal: Blood Adv Date: 2020-07-14
Authors: T Sauer; G Silling; C Groth; F Rosenow; U Krug; D Görlich; G Evers; J Albring; R Besoke; R M Mesters; C Müller-Tidow; T Kessler; T Büchner; W E Berdel; M Stelljes Journal: Bone Marrow Transplant Date: 2015-01-19 Impact factor: 5.483
Authors: Jan J Cornelissen; Alois Gratwohl; Richard F Schlenk; Jorge Sierra; Martin Bornhäuser; Gunnar Juliusson; Zdenek Råcil; Jacob M Rowe; Nigel Russell; Mohamad Mohty; Bob Löwenberg; Gerard Socié; Dietger Niederwieser; Gert J Ossenkoppele Journal: Nat Rev Clin Oncol Date: 2012-09-04 Impact factor: 66.675