Improved outcome in young adults with de novo acute myeloid leukemia in first remission, undergoing an allogeneic bone marrow transplant View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2007-06-25

AUTHORS

D Vicente, T Lamparelli, F Gualandi, D Occhini, A M Raiola, A Ibatici, M T Van Lint, M Gobbi, M Miglino, M Clavio, M Risso, F Frassoni, A Bacigalupo

ABSTRACT

We assessed the outcome of 170 patients with AML in first complete remission, aged 1–47 years (median 29), who had undergone an allogeneic BMT before or after 1990 (n=80 and n=90, respectively); all patients were prepared with cyclophosphamide and TBI; the median follow-up for surviving patients was 13 years. The donor was an HLA-identical sibling in 164 patients. Transplant-related mortality (TRM) was 30% before and 7% after 1990 (P<0.001); relapse-related death (RRD) was 26 and 11% (P=0.002); and actuarial 10-year survival was 42 and 79% (P<0.00001). Patients transplanted after 1990 were older, had a shorter interval diagnosis-BMT, had less FAB-M3 cases, received a higher dose of TBI, a higher marrow cell dose and combined (cyclosporine+methotrexate) GVHD prophylaxis. Patients relapsing after transplant had an actuarial survival of 0 vs 31% if grafted before or after 1990 (P=0.01), and their median follow-up exceeds 10 years. In conclusion, the overall survival of first remission AML undergoing an allogeneic BMT has almost doubled in the past two decades, despite older age and fewer M3 cases. Improvement has come not only from changes in transplant procedures, but also from effective rescue of patients relapsing after transplant. More... »

PAGES

349-354

Identifiers

URI

http://scigraph.springernature.com/pub.10.1038/sj.bmt.1705739

DOI

http://dx.doi.org/10.1038/sj.bmt.1705739

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1001598063

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/17589537


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42 acute myeloid leukemia
43 adults
44 age
45 allogeneic BMT
46 allogeneic bone marrow transplant
47 bone marrow transplant
48 cases
49 cell dose
50 changes
51 complete remission
52 conclusion
53 cyclophosphamide
54 de novo acute myeloid leukemia
55 death
56 decades
57 donors
58 dose
59 effective rescue
60 first complete remission
61 first remission
62 first remission AML
63 high dose
64 high marrow cell dose
65 improvement
66 leukemia
67 marrow cell dose
68 marrow transplant
69 mortality
70 myeloid leukemia
71 novo acute myeloid leukemia
72 older age
73 outcomes
74 overall survival
75 patients
76 procedure
77 prophylaxis
78 relapse-related death
79 remission
80 rescue
81 siblings
82 survival
83 transplant
84 transplant procedures
85 transplant-related mortality
86 years
87 young adults
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