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- Title
Influence of conditioning regimen intensity on outcomes post‐allogeneic hematopoietic cell transplantation for acute myeloid leukemia in complete morphological remission.
- Authors
Alfaro Moya, Tommy; Mattsson, Jonas; Remberger, Mats; Lipton, Jeffrey H.; Kim, Dennis D.; Viswabandya, Auro; Kumar, Rajat; Lam, Wilson; Law, Arjun D.; Gerbitz, Armin; Pasic, Ivan; Novitzky‐Basso, Igor; Michelis, Fotios V.
- Abstract
Introduction: The literature comparing outcomes between myeloablative (MAC) and reduced intensity conditioning (RIC) for acute myeloid leukemia (AML) is conflicting. Methods: We retrospectively analyzed 451 patients who underwent allogenic hematopoietic cell transplantation (alloHCT) for AML in complete remission (CR) with either RIC (n = 331) or MAC (n = 120) with the use of dual T‐cell depletion as graft‐versus‐host disease (GVHD) prophylaxis. Results: Univariate analysis demonstrated nonrelapse mortality (NRM) at 2 years was 19.1% for MAC and 22.5% for RIC (p =.44). Two‐year cumulative incidence of relapse (CIR) was 19.8% for MAC and 24.5% for RIC (p =.15). Two‐year overall survival (OS) was 61% and 53% for MAC and RIC, respectively (p =.02). Two‐year graft‐versus‐host disease relapse‐free survival (GRFS) was 40.8% for MAC and 33.7% for RIC (p =.30). A propensity score‐matched analysis was done matching patients for age, HLA match, in vivo T‐cell depletion, and Disease Risk Index (DRI). Two‐year OS was 67% for MAC, 66% for RIC (p =.95). A subgroup analysis identified that matched related donor transplants benefit from MAC with OS at 2 years 82.6% versus 57.3% for RIC (p =.006). Conclusions: In the matched‐related donor setting, MAC regimens may offer superior survival. Overall, for our cohort of predominantly in vivo T‐cell depleted patients the outcomes of MAC and RIC were similar.
- Subjects
HEMATOPOIETIC stem cell transplantation; ACUTE myeloid leukemia; CANCER remission; GRAFT versus host disease; OVERALL survival
- Publication
European Journal of Haematology, 2023, Vol 111, Issue 4, p553
- ISSN
0902-4441
- Publication type
Article
- DOI
10.1111/ejh.14041