Allogeneic hematopoietic cell transplantation for patients with AML aged 70 years or older in first remission. A study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation (EBMT).

Autores de IIS La Fe

• Jaime Sanz Caballer

  Autor

Participantes ajenos a IIS La Fe

• Maffini, Enrico
• Ngoya, Maud
• Galimard, Jacques-Emmanuel
• Harbi, Samia
• Kroger, Nicolaus
• Platzbecker, Uwe
• Sengeloev, Henrik
• Craddock, Charles
• Potter, Victoria
• Choi, Goda
• Chevallier, Patrice
• Stolzel, Friedrich
• Tholouli, Eleni
• Maertens, Johan
• Ciceri, Fabio
• Cornelissen, Jan
• Spyridonidis, Alexandros
• Lanza, Francesco
• Nagler, Arnon
• Mohty, Mohamad

Grupos

• Hematología y Hemoterapia

  

  Investigador Principal

  Javier De La Rubia Comos

Abstract

Accessibility to allogeneic hematopoietic cell transplantation (HCT) programs for older patients is growing constantly. We report on the clinical outcomes of a group of 701 adults aged =70 years, with acute myeloid leukemia (AML) in first complete remission (CR1), who received a first HCT, from HLA-matched sibling donors (MSD), 10/10 HLA-matched unrelated donors (UD), 9/10 HLA-mismatched unrelated donors (mUD) or haploidentical (Haplo) donors. The 2-year overall survival (OS) was 48.1%, leukemia-free survival (LFS) 45.3%, relapse incidence (RI) 25.2%, non-relapse mortality (NRM) 29.5% and GVHD-free, relapse-free survival (GRFS), 33.4%. Compared to MSD, patients transplanted from Haplo and UD presented lower RI (HR 0.46, 95% CI 0.25-0.8, p=0.02 and HR 0.44, 95% CI: 0.28-0.69, p=0.001, respectively); this translated into prolonged LFS for Haplo (HR 0.62, 95% CI: 0.39-0.99, p=0.04). Patients transplanted from mUD exhibited the highest NRM incidence (HR 2.33, 95% CI: 1.26-4.31, p=0.007). HCT in selected adult CR1 AML patients >70 years is feasible and could be associated with good clinical outcomes. Prospective clinical trials are warranted.

© 2023. The Author(s), under exclusive licence to Springer Nature Limited.

Keywords

• ACUTE MYELOID-LEUKEMIA; REDUCED-INTENSITY; RISK-ASSESSMENT; FREE SURVIVAL; DONOR; DISEASE; CYCLOPHOSPHAMIDE; OUTCOMES; GLOBULIN; IMPACT