Hematopoietic stem cell transplantation for adults with acute promyelocytic leukemia in the ATRA era: a survey of the European Cooperative Group for Blood and Marrow Transplantation

Autors de IIS La Fe

• 

  Miguel Ángel Sanz Alonso

  Autor

• 

  Javier De La Rubia Comos

  Autor

Autors aliens a IIS La Fe

• Labopin, M.
• Gorin, N-C
• Arcese, W.
• Meloni, G.
• Bacigalupo, A.
• Alessandrino, P.
• Carreras, E.
• Iriondo, A.
• Novitzky, N.
• Jacobs, P.
• Bandini, G.
• Lo-Coco, F.
• Frassoni, F.
• Rocha, V.
• EBMT

Abstract

We performed a survey of the European Cooperative Group for Blood and Marrow Transplantation to analyze the outcome of 625 acute promyelocytic leukemia (APL) patients transplanted with auto- or allogeneic-hematopoietic stem cell transplantation (autoHSCT, alloHSCT) after 1993, in first (CR1) or in second complete remission (CR2). Leukemia-free survival (LFS) at 5 years in CR1 was 69% for 149 patients autografted and 68% for 144 patients allografted, whereas in CR2, LFS was 51% in 195 autoHSCT and 59% in 137 alloHSCT recipients, respectively. In the group of autoHSCT for CR1 (n = 149), higher relapse incidence (RI) was associated with shorter time from diagnosis to transplant (< 7.6 months); transplant-related mortality (TRM) was increased in older patients (> 47 years), whereas for CR2, longer time from diagnosis to transplant (> 18 months) was associated with increased LFS and decreased RI. In the alloHSCT group for CR1 (n = 144), age (< 33 years) was associated with increased LFS and decreased TRM and for CR2 (n = 137), the use of mobilized peripheral blood stem cells was associated with decreased TRM. Female recipient, a female donor to male recipient and transplants performed before 1997 were associated with decreased RI. In conclusion, HSCT still appears to have a role in APL, especially for patients in CR2.

Keywords

• acute promyelocytic leukemia; autologousm stem cell transplantation; allogeneic stem cell transplantation