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OUTCOME OF ALLOGENEIC STEM CELL TRANSPLANTATION WITH ACTIVE DISEASE IN ACUTE MYELOID LEUKEMIA
Abstract
Introduction: Despite multiple lines of chemotherapy, some patients with acute myeloid leukemia (AML) can not achieve remission. The prognosis of these patients is quite poor and they should be evaluated for clinical trials, otherwise myeloablative conditioning regimens followed by allogeneic stem cell transplantation (Allo-SCT) should be performed to over come the active disease which is resistant to conventional doses and as it is the only curative option.
Method: In this study, we evaluated the outcome of AML patients who underwent Allo-SCT with active disease in our center retrospectively.
Results: A total of 161 AML patients underwent Allo-SCT between December 2009 and November 2018 at our center. 130 of them underwent Allo-SCT in complete remission while 31 of 161 had to undergo Allo-SCT with active disease due to refractoriness to salvage therapies. The median overall survival (OS) was7.9±2.8 months. 6-month OS was 25% and 1-year OS was only 6%. Progression-free survival (PFS) was 3.53±1.1 months. The transplant-related mortality rate was12.8%.
Conclusion: OS and PFS are short in patients who undergo Allo-SCT with active diseases on oveltreatment approaches and targeted therapies should be developed to overcome active disease that are refractory to conventional chemotherapies.
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Mohty M. Indications for HSCT in adults: acute myeloid leukaemia. In: Appertley J, Carreras E, Gluckan E, Masszi T, editors. The EBMT handbook – haematopoietic stem cell transplantation. 6. ed. Paris: ESH – European School of Haematology; 2012. p. 317-29.
Bishop MR, Tarantolo SR, Geller RB, Lynch JC, Bierman PJ, Pavletic ZS et al.A randomized, double-blind trial of filgrastim (granulocyte colony stimulating factor) versus placebo following allogeneic blood stem cell transplantation. Blood. 2000; 96(1):80-5.
Yanada M, Matsuo K, Emi N, Naoe T. Efficacy of allogeneic hematopoietic stem cell transplantation depends on cytogenetic risk for acute myeloid leukemia in first disease remission. Cancer. 2005; 103(8):1652-8.
Grimwade D, Walker H, Oliver F, Wheatley K, Harrison C, Harrison G et al. The importance of diagnostic cytogenetics on outcome in AML: analysis of 1,612 patients entered into the MRC AML 10 trial. Blood. 1998; 92(7):2322-33.
Slovak ML, Kopecky KJ, Cassileth PA, Harrington DH, Theil KS, Mohamed A, et al. Karyotypic analysis predicts outcome of preremission and postremission therapy in adult acute myeloid leukemia: a Southwest Oncology Group/ Eastern Cooperative Oncology Group Study. Blood. 2000; 96(13):4075-83.
Jourdan E, Boiron J-M, Dastugue N, Vey N, Marit G, Rigal-Huguet F, et al. Early allogeneic stem-cell transplantation for young adults with acute myeloblastic leukemia in first complete remission: an intent-to-treat longterm analysis of the BGMT experience. J Clin Oncol. 2005; 23(30):7676-84.
Kaspers GJ, Zwaan CM. Pediatric acute myeloid leukemia: towards high quality cure of all patients. Haematologica. 2007; 92(11):1519-32.
Martino R, Caballero MD, Pérez-Simón JA, Canals C, Solano C, Urbano-IspıÌzua A, et al. AML and allo PBSCT Subcommittees of the Spanish Group for Hematopoietic Transplantation. Evidence for a graft-versus-leukemia effect after allogeneic peripheral blood stem cell transplantation with reduced-intensity conditioning in acute myelogenous leukemia and myelodysplastic syndromes. Blood. 2002; 100(6):2243-5.
Döhner H, Estey E, Grimwade D, Amadori S, Appelbaum FR, Büchner T, et al. Diagnosis and management of AML in adults: 2017 ELN recommendations from an international expert panel. Blood. 2017; 129(4):424-47.
Rowlings PA, Przepiorka D, Klein JP, Gale RP, Passweg JR, Henslee-Downey PJ, et al. IBMTR Severity Index for grading acute graft-versus-host disease: retrospective comparison with Glucksberg grade. Br J Haematol. 1997; 97(4):855-64.
Filipovich AH, Weisdorf D, Pavletic S, Socie G, Wingard JR, Lee SJ, et al. National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: I. Diagnosis and staging working group report. Biol Blood Marrow Transpl. 2005;11(12):945–56.
Ivanoff S, Gruson B, Chantepie SP, Lemasle E, Merlusca L, Harrivel V, et al. 5â€Azacytidine treatment for relapsed or refractory acute myeloid leukemia after intensive chemotherapy. Am J Hematol. 2013; 88(7):601-5.
De-Mello RA, Pinho-Vaz C, Branca R, Campilho F, Rosales M, Roncon S, et al. Outcomes of allogeneic stem cell transplantation among patients with acute myeloid leukemia presenting active disease: Experience of a single European Comprehensive Cancer Center. Rev Assoc Med Bras. 2016; 62(7):641-6.
Chen AR, Alonzo TA, Woods WG, Arceci RJ. Current controversies: which patients with acute myeloid leukemia should receive a bone marrow transplantation? – An American view. Br J Haematol. 2002; 118(2):378-84.
Ganzel C, Sun Z, Cripe LD, Fernandez HF, Douer D, Rowe JM, et al. Very poor long-term survival in past and more recent studies for relapsed AML patients: The ECOG-ACRIN experience. Am J Hematol. 2018 Jun 15. doi: 10.1002/ajh.25162. [Epub ahead of print]
Tauro S, Craddock C, Peggs K, Begum G, Mahendra P, Cook G, et al. Allogeneic stem-cell transplantation using a reduced-intensity conditioning regimen has the capacity to produce durable remissions and long-term disease-free survival in patients with high-risk acute myeloid leukemia and myelodysplasia. J Clin Oncol. 2005; 23(36):9387-93.
Craddock C, Tauro S, Moss P, Grimwade D. Biology and management of relapsed acute myeloid leukemia. Br J Haematol. 2005; 129(1):18-34.
DOI: http://dx.doi.org/10.24125/sanamed.v15i1.397
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Copyright (c) 2020 Mehmet Bakirtas, Tugce Nur Yigenoglu, Semih Basci, Bahar Uncu Ulu, Nurgul Ozcan, Merih Kizil Cakar, Mehmet Sinan Dal, Fevzi Altuntas
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