Tomasz Czerw1, Myriam Labopin2,3,4, Norbert-Claude Gorin2,3,4, Sebastian Giebel1, Didier Blaise5, Giovanna Meloni6, Arnaud Pigneux7, Alberto Bosi8, Joan Veelken9, Felicetto Ferrara10, Nicolaas Schaap11, Roberto M Lemoli12,13, Jan J Cornelissen14, Eric Beohou3, Arnon Nagler2,15, Mohamad Mohty2,3,4. 1. Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Gliwice Branch, Gliwice, Poland. 2. Clinical Hematology and Cellular Therapy Department, The Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation Office, Hopital Saint-Antoine APHP, Paris, France. 3. INSERM UMRs 938, Paris, France. 4. Pierre and Marie Curie University, Paris, France. 5. Department of Transplantation and Cellular Therapy, Paoli Calmettes Institute, Marseille, France. 6. Department of Cellular Biotechnology and Hematology, "LaSapienza" University, Rome, Italy. 7. Department of Hematology and Cellular Therapy, University Hospital of Bordeaux, Bordeaux, France. 8. Bone Marrow Transplantation Unit, Department of Hematology, di Careggi Hospital, Florence, Italy. 9. Bone Marrow Transplantation Centre Leiden, Leiden University Hospital, Leiden, The Netherlands. 10. Division of Hematology and Stem Cell Transplantation Unit, Cardarelli Hospital, Naples, Italy. 11. Department of Hematology, Radboud University-Nijmegen Medical Centre, Nijmegen, The Netherlands. 12. Institute of Hematology and Medical Oncology, "L & A Seragnoli," St.Orsola-Malpighi University Hospital, Bologna University, Bologna, Italy. 13. Roberto M. Lemoli's current address: Division of Hematology, Department of Internal Medicine, University of Genoa, Genoa, Italy. 14. Department of Hematology, Erasmus University Medical Center Cancer Institute, Rotterdam, The Netherlands. 15. Hematology and Bone Marrow Transplantation, Chaim Sheba Medical Center, Tel Hashomer, Israel.
Abstract
BACKGROUND: Leukemia recurrence is a major cause of treatment failure after autologous stem cell transplantation for acute myeloid leukemia (AML). It usually occurs within the first 2 years after transplantation. The goal of the current retrospective study was to assess the follow-up of and characterize risk factors for outcome among patients who survived free of disease recurrence after this period. METHODS: The analysis included 3567 adults (median age, 45 years) with AML who underwent autografting during the first (86% of patients) or second (14% of patients) complete remission between 1990 and 2008. The stem cell source was the bone marrow in 32% of patients or the peripheral blood in 68% of patients. The median follow-up was 6.9 years. RESULTS: At 5 years and 10 years after transplantation, the probability of leukemia-free survival was 86% and 76%, respectively; the recurrence incidence was 11% and 16%, respectively; and the nonrecurrence mortality rate was 3% and 8%, respectively. The observed survival was decreased compared with the expected survival of the general European population. In a multivariate analysis, decreased probability of leukemia-free survival was demonstrated for patients who underwent peripheral blood autologous stem cell transplantation; had French-American-British subtypes M0, M6, or M7; and were of an older age. The same factors were found to be associated with an increased risk of disease recurrence. Nonrecurrence mortality was found to be affected by older age. CONCLUSIONS: The results of the current analysis indicate that late recurrences remain a major concern after autologous stem cell transplantation among patients with AML, indicating the need for close monitoring of minimal residual disease and additional leukemic control measures after transplantation. Cancer 2016;122:1880-7.
BACKGROUND:Leukemia recurrence is a major cause of treatment failure after autologous stem cell transplantation for acute myeloid leukemia (AML). It usually occurs within the first 2 years after transplantation. The goal of the current retrospective study was to assess the follow-up of and characterize risk factors for outcome among patients who survived free of disease recurrence after this period. METHODS: The analysis included 3567 adults (median age, 45 years) with AML who underwent autografting during the first (86% of patients) or second (14% of patients) complete remission between 1990 and 2008. The stem cell source was the bone marrow in 32% of patients or the peripheral blood in 68% of patients. The median follow-up was 6.9 years. RESULTS: At 5 years and 10 years after transplantation, the probability of leukemia-free survival was 86% and 76%, respectively; the recurrence incidence was 11% and 16%, respectively; and the nonrecurrence mortality rate was 3% and 8%, respectively. The observed survival was decreased compared with the expected survival of the general European population. In a multivariate analysis, decreased probability of leukemia-free survival was demonstrated for patients who underwent peripheral blood autologous stem cell transplantation; had French-American-British subtypes M0, M6, or M7; and were of an older age. The same factors were found to be associated with an increased risk of disease recurrence. Nonrecurrence mortality was found to be affected by older age. CONCLUSIONS: The results of the current analysis indicate that late recurrences remain a major concern after autologous stem cell transplantation among patients with AML, indicating the need for close monitoring of minimal residual disease and additional leukemic control measures after transplantation. Cancer 2016;122:1880-7.
Authors: Juliane Wagner; Viktoria Pfannenstiel; Anja Waldmann; Judith W J Bergs; Boris Brill; Sabine Huenecke; Thomas Klingebiel; Franz Rödel; Christian J Buchholz; Winfried S Wels; Peter Bader; Evelyn Ullrich Journal: Front Immunol Date: 2017-06-12 Impact factor: 7.561
Authors: Grzegorz Helbig; Anna Koclęga; Krzysztof Woźniczka; Małgorzata Kopera; Sławomira Kyrcz-Krzemień Journal: Pathol Oncol Res Date: 2017-06-28 Impact factor: 3.201