Stelljes, Matthias and Krug, Utz and Beelen, Dietrich W. and Braess, Jan and Sauerland, Maria C. and Heinecke, Achim and Ligges, Sandra and Sauer, Tim and Tschanter, Petra and Thoennissen, Gabriela B. and Berning, Bjoerna and Kolb, Hans J. and Reichle, Albrecht and Holler, Ernst and Schwerdtfeger, Rainer and Arnold, Renate and Scheid, Christoph and Mueller-Tidow, Carsten and Woermann, Bernhard J. and Hiddemann, Wolfgang and Berdel, Wolfgang E. and Buechner, Thomas (2014) Allogeneic Transplantation Versus Chemotherapy as Postremission Therapy for Acute Myeloid Leukemia: A Prospective Matched Pairs Analysis. JOURNAL OF CLINICAL ONCOLOGY, 32 (4). 288-+. ISSN 0732-183X, 1527-7755
Full text not available from this repository. (Request a copy)Abstract
Purpose The majority of patients with acute myeloid leukemia (AML) who achieve complete remission (CR) relapse with conventional postremission chemotherapy. Allogeneic stem-cell transplantation (alloSCT) might improve survival at the expense of increased toxicity. It remains unknown for which patients alloSCT is preferable. Patients and Methods We compared the outcome of 185 matched pairs of a large multicenter clinical trial (AMLCG99). Patients younger than 60 years who underwent alloSCT in first remission (CR1) were matched to patients who received conventional postremission therapy. The main matching criteria were AML type, cytogenetic risk group, patient age, and time in first CR. Results In the overall pairwise compared AML population, the projected 7-year overall survival (OS) rate was 58% for the alloSCT and 46% for the conventional postremission treatment group (P = .037; log-rank test). Relapse-free survival (RFS) was 52% in the alloSCT group compared with 33% in the control group (P < .001). OS was significantly better for alloSCT in patient subgroups with nonfavorable chromosomal aberrations, patients older than 45 years, and patients with secondary AML or high-risk myelodysplastic syndrome. For the entire patient cohort, postremission therapy was an independent factor for OS (hazard ratio, 0.66; 95% CI, 0.49 to 0.89 for alloSCT v conventional chemotherapy), among age, cytogenetics, and bone marrow blasts after the first induction cycle. Conclusion AlloSCT is the most potent postremission therapy for AML and is particularly active for patients 45 to 59 years of age and/or those with high-risk cytogenetics.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | STEM-CELL TRANSPLANTATION; ACUTE MYELOGENOUS LEUKEMIA; 1ST COMPLETE REMISSION; AML-COOPERATIVE-GROUP; HIGH-DOSE CYTARABINE; GENE-MUTATIONS; PROLONGED MAINTENANCE; EUROPEAN LEUKEMIANET; FAVORABLE PROGNOSIS; NORMAL KARYOTYPE; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin III (Hämatologie und Internistische Onkologie) |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 28 Nov 2019 09:26 |
| Last Modified: | 28 Nov 2019 09:26 |
| URI: | https://pred.uni-regensburg.de/id/eprint/10751 |
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