Post remission consolidation by autologous HCT for AML in CR1, negative implications for subsequent allogeneic HCT in CR2. A Study by the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation (EBMT).

Passweg, J R; Labopin, M; Christopeit, M; Cornelissen, J; Pabst, Thomas; Socié, G; Russel, N; Yakoub-Agha, I; Blaise, D; Gedde-Dahl, T; Labussière-Wallet, H; Malladi, R; Forcade, E; Maury, S; Polge, E; Lanza, F; Gorin, N C; Mohty, M; Nagler, A (2020). Post remission consolidation by autologous HCT for AML in CR1, negative implications for subsequent allogeneic HCT in CR2. A Study by the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation (EBMT). Biology of blood and marrow transplantation, 26(4), pp. 659-664. Elsevier 10.1016/j.bbmt.2019.11.021

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After autologous hematopoetic cell transplantation, (HCT in 1st complete remission (CR1), patients with acute myeloid leukemia (AML) may relapse and undergo allogeneic HCT in CR2. The aim of this study was to analyze outcome of allogeneic HCT performed in CR2 comparing patients with prior consolidation by autologous HCT vs. patients with chemotherapy consolidation. Included were 2619 adults, with allogeneic HCT in CR2, in 2000-2017 with (n=417) or without (n=2202) prior autologous HCT. Patient groups were not entirely comparable; patients with prior autologous HCT were younger, had less often a favorable cytogenetic profile, had more commonly donors other than matched siblings and more often received reduced intensity conditioning (RIC) conditioning. In multivariate analysis non relapse mortality (NRM) risks in patients with prior autologous HCT were 1.34 (1.07-1.67), p=0.01 after adjustment for age, cytogenetic risk, transplant year, donor, conditioning intensity, sex matching, interval diagnosis-relapse and relapse-allogeneic HCT as compared to chemotherapy consolidation. Similarly, risks of events in leukemia free survival and graft versus host disease, relapse free survival were higher with prior autologous HCT, 1.17 (1.01-1.35), p=0.03 and 1.18 (1.03-1.35) p= 0.02, respectively. Risk of death was also higher 1.13 (0.97-1.32) p=0.1 but this was not significant. Post remission consolidation with autologous HCT for AML in CR1 increases toxicity of subsequent allogeneic HCT in CR2.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Medical Oncology

UniBE Contributor:

Pabst Müller, Thomas Niklaus

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1083-8791

Publisher:

Elsevier

Language:

English

Submitter:

Rebeka Gerber

Date Deposited:

17 Dec 2019 12:53

Last Modified:

22 Nov 2020 02:30

Publisher DOI:

10.1016/j.bbmt.2019.11.021

PubMed ID:

31759159

Uncontrolled Keywords:

AML autologous consolidation subsequent allogeneic HCT toxicity

BORIS DOI:

10.7892/boris.136286

URI:

https://boris.unibe.ch/id/eprint/136286

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