Feasibility and efficacy of salvage allogeneic stem cell transplantation in AML patients relapsing after autologous stem cell transplantation.

Shumilov, Evgenii; Shakhanova, Inna; Flach, Johanna; Schmidt, Nicole; Buerki, Susanne; Legros, Myriam; Kronig, Marie-Noëlle; Ofran, Yishai; Gerull, Sabine; Medinger, Michael; Mansouri Taleghani, Behrouz; Passweg, Jakob; Halter, Jörg; Bacher, Ulrike; Pabst, Thomas (2022). Feasibility and efficacy of salvage allogeneic stem cell transplantation in AML patients relapsing after autologous stem cell transplantation. Bone marrow transplantation, 57(2), pp. 224-231. Springer Nature 10.1038/s41409-021-01521-5

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Autologous hematopoietic cell transplantation (HCT) is suitable for consolidation of favorable-/intermediate-risk AML patients in CR1. However, ~50% of AML patients relapse after autologous HCT, and efficacy of subsequent salvage strategies including allogeneic HCT remains unclear. We studied 123 consecutive patients with newly diagnosed AML undergoing high-dose chemotherapy (HDCT)/autologous HCT in CR1. In relapsing patients afterwards, we analyzed salvage treatments and outcomes focusing particularly on salvage allogeneic HCT. Of 123 patients, 64 (52%) relapsed after autologous HCT. Subsequently, 13 (21%) received palliative therapy, whereas 51 (79%) proceeded to salvage therapy with a curative intent. Of the 47 patients with a curative intent and who did not proceed directly to allogeneic HCT, 23 (49%) achieved CR2 or had ongoing hematologic CR1 despite molecular relapse. Finally, 30 patients (47%) received allogeneic HCT with estimated 3-year leukemia-free and overall survival rates of 33% and 43%. Hematologic remission at allogeneic HCT and lack of acute GvHD had a positive impact on OS and LFS (p < 0.05). Our study suggests that almost 80% of AML patients can undergo salvage therapy following relapse after front-line HDCT/autologous HCT. Allogeneic HCT can provide cure in one third of patients relapsing after front-line HDCT/autologous HCT.

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

UniBE Contributor:

Bürki, Susanne; Legros, Myriam; Kronig, Marie-Noëlle; Mansouri Taleghani, Behrouz; Bacher, Vera Ulrike and Pabst, Thomas Niklaus

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1476-5365

Publisher:

Springer Nature

Language:

English

Submitter:

Pierrette Durand Lüthi

Date Deposited:

26 Nov 2021 15:09

Last Modified:

10 Feb 2022 00:12

Publisher DOI:

10.1038/s41409-021-01521-5

PubMed ID:

34775480

BORIS DOI:

10.48350/161607

URI:

https://boris.unibe.ch/id/eprint/161607

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