Hematopoietic cell transplantation in patients with intermediate and high-risk AML: results from the randomized Study Alliance Leukemia (SAL) AML 2003 ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2015-05

AUTHORS

J Schetelig, M Schaich, K Schäfer-Eckart, M Hänel, W E Aulitzky, H Einsele, N Schmitz, W Rösler, M Stelljes, C D Baldus, A D Ho, A Neubauer, H Serve, J Mayer, W E Berdel, B Mohr, U Oelschlägel, S Parmentier, C Röllig, M Kramer, U Platzbecker, T Illmer, C Thiede, M Bornhäuser, G Ehninger

ABSTRACT

The optimal timing of allogeneic hematopoietic stem cell transplantation (HCT) in acute myeloid leukemia (AML) is controversial. We report on 1179 patients with a median age of 48 years who were randomized upfront. In the control arm, sibling HCT was scheduled in the first complete remission for intermediate-risk or high-risk AML and matched unrelated HCT in complex karyotype AML. In the experimental arm, matched unrelated HCT in first remission was offered also to patients with an FLT3-ITD (FMS-like tyrosine kinase 3-internal tandem duplication) allelic ratio >0.8, poor day +15 marrow blast clearance and adverse karyotypes. Further, allogeneic HCT was recommended in high-risk AML to be performed in aplasia after induction chemotherapy. In the intent-to-treat (ITT) analysis, superiority of the experimental transplant strategy could not be shown with respect to overall survival (OS) or event-free survival. As-treated analyses suggest a profound effect of allogeneic HCT on OS (HR 0.73; P=0.002) and event-free survival (HR 0.67; P<0.001). In high-risk patients, OS was significantly improved after allogeneic HCT in aplasia (HR 0.64; P=0.046) and after HCT in remission (HR 0.74; P=0.03). Although superiority of one study arm could not be demonstrated in the ITT analysis, secondary analyses suggest that early allogeneic HCT is a promising strategy for patients with high-risk AML. More... »

PAGES

1060

Identifiers

URI

http://scigraph.springernature.com/pub.10.1038/leu.2014.335

DOI

http://dx.doi.org/10.1038/leu.2014.335

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1003749845

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/25434303


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