Stelljes, Matthias and Beelen, Dietrich W. and Braess, Jan and Sauerland, Maria C. and Heinecke, Achim and Berning, Bjoerna and Kolb, Hans J. and Holler, Ernst and Schwerdtfeger, Rainer and Arnold, Renate and Spiekermann, Karsten and Mueller-Tidow, Carsten and Serve, Hubert L. and Silling, Gerda and Hiddemann, Wolfgang and Berdel, Wolfgang E. and Buechner, Thomas and Kienast, Joachim (2011) Allogeneic transplantation as post-remission therapy for cytogenetically high-risk acute myeloid leukemia: landmark analysis from a single prospective multicenter trial. HAEMATOLOGICA-THE HEMATOLOGY JOURNAL, 96 (7). pp. 972-979. ISSN 0390-6078,
Full text not available from this repository. (Request a copy)Abstract
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.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | STEM-CELL TRANSPLANTATION; 1ST COMPLETE REMISSION; MARROW TRANSPLANTATION; ADULT PATIENTS; UNRELATED DONORS; SIBLING DONORS; INDUCTION; SURVIVAL; RELAPSE; CHEMOTHERAPY; allogeneic stem cell transplantation; acute myeloid leukemia; high-risk; cytogenetics; first complete remission |
| 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: | 08 Jun 2020 10:47 |
| Last Modified: | 08 Jun 2020 10:47 |
| URI: | https://pred.uni-regensburg.de/id/eprint/20586 |
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