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- Title
Superior transplantation outcomes of 8/8-matched unrelated donors as well as matched siblings to autologous transplantation for acute myeloid leukemia with intermediate cytogenetics in first remission.
- Authors
Cho, Byung‐Sik; Kim, Jung‐Ho; Yoon, Jae‐Ho; Shin, Seung‐Hwan; Yahng, Seung‐Ah; Lee, Sung‐Eun; Eom, Ki‐Seong; Kim, Yoo‐Jin; Lee, Seok; Min, Chang‐Ki; Cho, Seok‐Goo; Kim, Dong‐Wook; Lee, Jong‐Wook; Min, Woo‐Sung; Park, Chong‐Won; Kim, Hee‐Je
- Abstract
Objectives For patients with acute myeloid leukemia in first complete remission ( AML CR1) lacking HLA-matched sibling donors ( MSD), 8/8-matched unrelated donors ( URD) are mostly used in cases with poor-risk features. For AML CR1 with intermediate cytogenetics, however, the benefit of 8/8-matched URD should be compared with non-allogeneic therapies as well as MSD. Methods To address this issue, we assessed the transplantation outcomes of 8/8-matched URD ( n = 54) compared with MSD ( n = 145) or autologous transplantation ( n = 89) for AML CR1 with intermediate cytogenetics. Results In multivariate analyses, 8/8-matched URD had comparable 6-yr overall survival (OS, P = 0.997), disease-free survival ( DFS, P = 0.951), and relapse ( P = 0.672) to MSD, whereas 8/8-matched URD had a higher OS ( P = 0.070) and DFS ( P = 0.035) with lower relapse ( P = 0.009) than autologous transplantation. No difference in non-relapse mortality was observed according to donor type. Notably, these equivalent or superior outcomes of 8/8-matched URD compared with MSD or autologous transplantation, respectively, were particularly evident in patients without poor-risk features ( n = 200), such as older age, hyperleukocytosis at diagnosis, and myelodysplasia-related changes, who are not usual candidates for URD transplantation. Conclusions These results indicate that 8/8-matched URD are feasible next option in AML CR1 with intermediate cytogenetics, when lacking MSD, even in patients without poor-risk features.
- Subjects
ACUTE myeloid leukemia; DISEASE remission; BLOOD donors; CYTOGENETICS; AUTOTRANSPLANTATION; DISEASE relapse; PATIENTS
- Publication
European Journal of Haematology, 2013, Vol 90, Issue 5, p365
- ISSN
0902-4441
- Publication type
Article
- DOI
10.1111/ejh.12089