TY - JOUR
T1 - Conditioning intensity in secondary AML with prior myelodysplastic syndrome/myeloproliferative disorders
T2 - An EBMT ALWP study
AU - Sengsayadeth, Salyka
AU - Gatwood, Katie S.
AU - Boumendil, Ariane
AU - Labopin, Myriam
AU - Finke, Jürgen
AU - Ganser, Arnold
AU - Stelljes, Matthias
AU - Ehninger, Gerhard
AU - Beelen, Dietrich
AU - Niederwieser, Dietger
AU - Blaise, Didier
AU - Dreger, Peter
AU - Mufti, Ghulam
AU - Chevallier, Patrice
AU - Mailhol, Audrey
AU - Gilleece, Maria H.
AU - Gorin, Norbert
AU - Esteve, Jordi
AU - Ciceri, Fabio
AU - Baron, Frederic
AU - Schmid, Christoph
AU - Giebel, Sebastian
AU - Mohty, Mohamad
AU - Savani, Bipin N.
AU - Nagler, Arnon
PY - 2018/8/28
Y1 - 2018/8/28
N2 - Patients with secondary AML (sAML) with antecedent myelodysplastic syndrome (MDS) or myeloproliferative neoplasms (MPNs) tend to have high-risk disease based on the older age of patients, high-risk cytogenetics, and higher number of prior treatments. Allogeneic hematopoietic cell transplant (HCT) is the only potentially curative therapy available. Eight hundred and two adults with sAML and prior MDS/MPN who received a first HCT between 2000 and 2016 were included in the European Society for Blood and Marrow Transplant (EBMT) Acute Leukemia Working Party (ALWP) study. Median age of the cohort was 59.6 years (range, 18.6-78.6 years). Myeloablative conditioning (MAC) was given to 40% of patients, and 60% received reduced-intensity conditioning (RIC). Overall, the 2-year cumulative incidence of relapse (RI) was 37%, leukemia-free survival (LFS) was 40%, overall survival (OS) was 46%, nonrelapsemortality (NRM) was 23%, and chronic graft-versus-host disease (cGVHD) was 39%. In univariate analysis, a statistical difference between conditioning regimens 6 months after HCT in favor of theMAC group was noted with regard to RI (hazard ratio [HR], 1.47; P 5 .03), LFS (HR, 1.43; P 5 .01), and OS (HR, 1.55; P, .05). There was no difference in the cumulative incidence of NRM (HR, 1.38; P 5 .15). This effect was similarly seen in multivariate analysis (MVA): cumulative incidence of relapse (HR, 1.79; P, .05), LFS (HR, 1.43; P 5 .02), and OS (HR, 1.53; P 5 .005) with no difference in NRM (HR, 1; P 5 .98). This EBMT ALWP analysis suggests that long-term survival can be achieved in patients with sAML with antecedent MDS/MPN and that MAC is a suitable conditioning regimen in patients with sAML.
AB - Patients with secondary AML (sAML) with antecedent myelodysplastic syndrome (MDS) or myeloproliferative neoplasms (MPNs) tend to have high-risk disease based on the older age of patients, high-risk cytogenetics, and higher number of prior treatments. Allogeneic hematopoietic cell transplant (HCT) is the only potentially curative therapy available. Eight hundred and two adults with sAML and prior MDS/MPN who received a first HCT between 2000 and 2016 were included in the European Society for Blood and Marrow Transplant (EBMT) Acute Leukemia Working Party (ALWP) study. Median age of the cohort was 59.6 years (range, 18.6-78.6 years). Myeloablative conditioning (MAC) was given to 40% of patients, and 60% received reduced-intensity conditioning (RIC). Overall, the 2-year cumulative incidence of relapse (RI) was 37%, leukemia-free survival (LFS) was 40%, overall survival (OS) was 46%, nonrelapsemortality (NRM) was 23%, and chronic graft-versus-host disease (cGVHD) was 39%. In univariate analysis, a statistical difference between conditioning regimens 6 months after HCT in favor of theMAC group was noted with regard to RI (hazard ratio [HR], 1.47; P 5 .03), LFS (HR, 1.43; P 5 .01), and OS (HR, 1.55; P, .05). There was no difference in the cumulative incidence of NRM (HR, 1.38; P 5 .15). This effect was similarly seen in multivariate analysis (MVA): cumulative incidence of relapse (HR, 1.79; P, .05), LFS (HR, 1.43; P 5 .02), and OS (HR, 1.53; P 5 .005) with no difference in NRM (HR, 1; P 5 .98). This EBMT ALWP analysis suggests that long-term survival can be achieved in patients with sAML with antecedent MDS/MPN and that MAC is a suitable conditioning regimen in patients with sAML.
UR - http://www.scopus.com/inward/record.url?scp=85060245345&partnerID=8YFLogxK
U2 - 10.1182/bloodadvances.2018019976
DO - 10.1182/bloodadvances.2018019976
M3 - Article
C2 - 30143527
AN - SCOPUS:85060245345
SN - 2473-9529
VL - 2
SP - 2127
EP - 2135
JO - Blood Advances
JF - Blood Advances
IS - 16
ER -