Unrelated donor versus matched sibling donor in adults with acute myeloid leukemia in first relapse: an ALWP-EBMT study
Abstract Background Allogeneic stem cell transplantation is the only curative option for patients with acute myeloid leukemia (AML) experiencing relapse. Either matched sibling donor (MSD) or unrelated donor (UD) is indicated. Methods We analyzed 1554 adults with AML transplanted from MSD (n = 961)...
| Main Authors: | , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2016-09-01
|
| Series: | Journal of Hematology & Oncology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13045-016-0321-y |
| _version_ | 1818380709540134912 |
|---|---|
| author | Annalisa Ruggeri Giorgia Battipaglia Myriam Labopin Gerhard Ehninger Dietrich Beelen Johanna Tischer Arnold Ganser Rainer Schwerdtfeger Bertram Glass Jurgen Finke Mauricette Michallet Matthias Stelljes Pavel Jindra Renate Arnold Nicolaus Kröger Mohamad Mohty Arnon Nagler |
| author_facet | Annalisa Ruggeri Giorgia Battipaglia Myriam Labopin Gerhard Ehninger Dietrich Beelen Johanna Tischer Arnold Ganser Rainer Schwerdtfeger Bertram Glass Jurgen Finke Mauricette Michallet Matthias Stelljes Pavel Jindra Renate Arnold Nicolaus Kröger Mohamad Mohty Arnon Nagler |
| author_sort | Annalisa Ruggeri |
| collection | DOAJ |
| description | Abstract Background Allogeneic stem cell transplantation is the only curative option for patients with acute myeloid leukemia (AML) experiencing relapse. Either matched sibling donor (MSD) or unrelated donor (UD) is indicated. Methods We analyzed 1554 adults with AML transplanted from MSD (n = 961) or UD (n = 593, HLA-matched 10/10, n = 481; 9/10, n = 112). Compared to MSD, UD recipients were older (49 vs 52 years, p = 0.001), transplanted more recently (2009 vs 2006, p = 0.001), and with a longer interval to transplant (10 vs 9 months, p = 0.001). Conditioning regimen was more frequently myeloablative for patients transplanted with a MSD (61 vs 46 %, p = 0.001). Median follow-up was 28 (range 3–157) months. Results Cumulative incidence (CI) of neutrophil engraftment (p = 0.07), grades II–IV acute GVHD (p = 0.11), chronic GVHD (p = 0.9), and non-relapse mortality (NRM, p = 0.24) was not different according to the type of donor. At 2 years, CI of relapse (relapse incidence (RI)) was 57 vs 49 % (p = 0.001). Leukemia-free survival (LFS) at 2 years was 21 vs 26 % (p = 0.001), and overall survival (OS) was 26 vs 33 % (p = 0.004) for MSD vs UD, respectively. Chronic GVHD as time-dependent variable was associated with lower RI (HR 0.78, p = 0.05), higher NRM (HR 1.71, p = 0.001), and higher OS (HR 0.69, p = 0.001). According to HLA match, RI was 57 vs 50 vs 45 %, (p = 0.001) NRM was 23 vs 23 vs 29 % (p = 0.26), and LFS at 2 years was 21 vs 27 vs 25 % (p = 0.003) for MSD, 10/10, and 9/10 UD, respectively. In multivariate analysis adjusted for differences between the two groups, UD was associated with lower RI (HR 0.76, p = 0.001) and higher LFS (HR 0.83, p = 0.001) compared to MSD. Interval between diagnosis and transplant was the other factor associated with better outcomes (RI (HR 0.62, p < 0.001) and LFS (HR 0.67, p < 0.001)). Conclusions Transplantation using UD was associated with better LFS and lower RI compared to MSD for high-risk patients with AML transplanted in first relapse. |
| first_indexed | 2024-12-14T02:23:00Z |
| format | Article |
| id | doaj.art-e5135234ac2140389d8a22aad0b4fb06 |
| institution | Directory Open Access Journal |
| issn | 1756-8722 |
| language | English |
| last_indexed | 2024-12-14T02:23:00Z |
| publishDate | 2016-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Hematology & Oncology |
| spelling | doaj.art-e5135234ac2140389d8a22aad0b4fb062022-12-21T23:20:27ZengBMCJournal of Hematology & Oncology1756-87222016-09-01911810.1186/s13045-016-0321-yUnrelated donor versus matched sibling donor in adults with acute myeloid leukemia in first relapse: an ALWP-EBMT studyAnnalisa Ruggeri0Giorgia Battipaglia1Myriam Labopin2Gerhard Ehninger3Dietrich Beelen4Johanna Tischer5Arnold Ganser6Rainer Schwerdtfeger7Bertram Glass8Jurgen Finke9Mauricette Michallet10Matthias Stelljes11Pavel Jindra12Renate Arnold13Nicolaus Kröger14Mohamad Mohty15Arnon Nagler16Service d’Hématologie et Thérapie Cellulaire, Hôpital Saint Antoine, AP-HPService d’Hématologie et Thérapie Cellulaire, Hôpital Saint Antoine, AP-HPService d’Hématologie et Thérapie Cellulaire, Hôpital Saint Antoine, AP-HPMedical Clinic and Polyclinic, University Hospital Carl Gustav Carus, Technical University DresdenDepartment of Bone Marrow Transplantation, University Hospital EssenDepartment of Internal Medicine III, UH of Munich (LMU)Department of Hematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical SchoolDepartment of Haematology, Oncology Helios-Klinikum Berlin-BuchDepartment of Hematology, Oncology and Stem Cell Transplantation, Asklepios Hospital St. GeorgDepartment of Hematology/Oncology and Stem Cell Transplantation, University Medical CenterDepartment of Hematology, Lyon-Sud Hospital, Hospices Civils de LyonDepartment of Medicine A, University of MuensterDepartments of Hematology/Oncology, Charles University HospitalCharité UniversitatsmedizinUniversity Medical Center Hamburg-EppendorfService d’Hématologie et Thérapie Cellulaire, Hôpital Saint Antoine, AP-HPUniversité Pierre and Marie CurieAbstract Background Allogeneic stem cell transplantation is the only curative option for patients with acute myeloid leukemia (AML) experiencing relapse. Either matched sibling donor (MSD) or unrelated donor (UD) is indicated. Methods We analyzed 1554 adults with AML transplanted from MSD (n = 961) or UD (n = 593, HLA-matched 10/10, n = 481; 9/10, n = 112). Compared to MSD, UD recipients were older (49 vs 52 years, p = 0.001), transplanted more recently (2009 vs 2006, p = 0.001), and with a longer interval to transplant (10 vs 9 months, p = 0.001). Conditioning regimen was more frequently myeloablative for patients transplanted with a MSD (61 vs 46 %, p = 0.001). Median follow-up was 28 (range 3–157) months. Results Cumulative incidence (CI) of neutrophil engraftment (p = 0.07), grades II–IV acute GVHD (p = 0.11), chronic GVHD (p = 0.9), and non-relapse mortality (NRM, p = 0.24) was not different according to the type of donor. At 2 years, CI of relapse (relapse incidence (RI)) was 57 vs 49 % (p = 0.001). Leukemia-free survival (LFS) at 2 years was 21 vs 26 % (p = 0.001), and overall survival (OS) was 26 vs 33 % (p = 0.004) for MSD vs UD, respectively. Chronic GVHD as time-dependent variable was associated with lower RI (HR 0.78, p = 0.05), higher NRM (HR 1.71, p = 0.001), and higher OS (HR 0.69, p = 0.001). According to HLA match, RI was 57 vs 50 vs 45 %, (p = 0.001) NRM was 23 vs 23 vs 29 % (p = 0.26), and LFS at 2 years was 21 vs 27 vs 25 % (p = 0.003) for MSD, 10/10, and 9/10 UD, respectively. In multivariate analysis adjusted for differences between the two groups, UD was associated with lower RI (HR 0.76, p = 0.001) and higher LFS (HR 0.83, p = 0.001) compared to MSD. Interval between diagnosis and transplant was the other factor associated with better outcomes (RI (HR 0.62, p < 0.001) and LFS (HR 0.67, p < 0.001)). Conclusions Transplantation using UD was associated with better LFS and lower RI compared to MSD for high-risk patients with AML transplanted in first relapse.http://link.springer.com/article/10.1186/s13045-016-0321-yAcute myeloid leukemiaRelapseMatched sibling donorUnrelated donor |
| spellingShingle | Annalisa Ruggeri Giorgia Battipaglia Myriam Labopin Gerhard Ehninger Dietrich Beelen Johanna Tischer Arnold Ganser Rainer Schwerdtfeger Bertram Glass Jurgen Finke Mauricette Michallet Matthias Stelljes Pavel Jindra Renate Arnold Nicolaus Kröger Mohamad Mohty Arnon Nagler Unrelated donor versus matched sibling donor in adults with acute myeloid leukemia in first relapse: an ALWP-EBMT study Journal of Hematology & Oncology Acute myeloid leukemia Relapse Matched sibling donor Unrelated donor |
| title | Unrelated donor versus matched sibling donor in adults with acute myeloid leukemia in first relapse: an ALWP-EBMT study |
| title_full | Unrelated donor versus matched sibling donor in adults with acute myeloid leukemia in first relapse: an ALWP-EBMT study |
| title_fullStr | Unrelated donor versus matched sibling donor in adults with acute myeloid leukemia in first relapse: an ALWP-EBMT study |
| title_full_unstemmed | Unrelated donor versus matched sibling donor in adults with acute myeloid leukemia in first relapse: an ALWP-EBMT study |
| title_short | Unrelated donor versus matched sibling donor in adults with acute myeloid leukemia in first relapse: an ALWP-EBMT study |
| title_sort | unrelated donor versus matched sibling donor in adults with acute myeloid leukemia in first relapse an alwp ebmt study |
| topic | Acute myeloid leukemia Relapse Matched sibling donor Unrelated donor |
| url | http://link.springer.com/article/10.1186/s13045-016-0321-y |
| work_keys_str_mv | AT annalisaruggeri unrelateddonorversusmatchedsiblingdonorinadultswithacutemyeloidleukemiainfirstrelapseanalwpebmtstudy AT giorgiabattipaglia unrelateddonorversusmatchedsiblingdonorinadultswithacutemyeloidleukemiainfirstrelapseanalwpebmtstudy AT myriamlabopin unrelateddonorversusmatchedsiblingdonorinadultswithacutemyeloidleukemiainfirstrelapseanalwpebmtstudy AT gerhardehninger unrelateddonorversusmatchedsiblingdonorinadultswithacutemyeloidleukemiainfirstrelapseanalwpebmtstudy AT dietrichbeelen unrelateddonorversusmatchedsiblingdonorinadultswithacutemyeloidleukemiainfirstrelapseanalwpebmtstudy AT johannatischer unrelateddonorversusmatchedsiblingdonorinadultswithacutemyeloidleukemiainfirstrelapseanalwpebmtstudy AT arnoldganser unrelateddonorversusmatchedsiblingdonorinadultswithacutemyeloidleukemiainfirstrelapseanalwpebmtstudy AT rainerschwerdtfeger unrelateddonorversusmatchedsiblingdonorinadultswithacutemyeloidleukemiainfirstrelapseanalwpebmtstudy AT bertramglass unrelateddonorversusmatchedsiblingdonorinadultswithacutemyeloidleukemiainfirstrelapseanalwpebmtstudy AT jurgenfinke unrelateddonorversusmatchedsiblingdonorinadultswithacutemyeloidleukemiainfirstrelapseanalwpebmtstudy AT mauricettemichallet unrelateddonorversusmatchedsiblingdonorinadultswithacutemyeloidleukemiainfirstrelapseanalwpebmtstudy AT matthiasstelljes unrelateddonorversusmatchedsiblingdonorinadultswithacutemyeloidleukemiainfirstrelapseanalwpebmtstudy AT paveljindra unrelateddonorversusmatchedsiblingdonorinadultswithacutemyeloidleukemiainfirstrelapseanalwpebmtstudy AT renatearnold unrelateddonorversusmatchedsiblingdonorinadultswithacutemyeloidleukemiainfirstrelapseanalwpebmtstudy AT nicolauskroger unrelateddonorversusmatchedsiblingdonorinadultswithacutemyeloidleukemiainfirstrelapseanalwpebmtstudy AT mohamadmohty unrelateddonorversusmatchedsiblingdonorinadultswithacutemyeloidleukemiainfirstrelapseanalwpebmtstudy AT arnonnagler unrelateddonorversusmatchedsiblingdonorinadultswithacutemyeloidleukemiainfirstrelapseanalwpebmtstudy |