HLA-Identical Sibling Allogeneic Transplants versus Chemotherapy in Acute Myelogenous Leukemia with t(8;21) in First Complete Remission: Collaborative Study between the German AML Intergroup and CIBMTR
Year: 2007
Type: article
Abstract: We studied the role of HLA-matched sibling hematopoietic cell transplantation (HCT) in treating t(8;21) acute myelogenous leukemia (AML) in first remission. Outcomes of 118 patients receiving HCT and reported to the Center for International Blood and Marrow Transplant Research were compared with 132 similar patients receiving chemotherapy selected from 8 German AML Intergroup multicenter trials. Characteristics of the cohorts were similar except that chemotherapy recipients were significantly older. To adjust for time to treatment bias, outcomes were compared using left-truncated Cox regression models. Transplants were associated with higher treatment-related mortality (TRM; relative risk [RR] 6.76, 95% confidence interval [CI] 2.95-15.45, P < .001), lower relapse (RR 0.47, 95% CI 0.25-0.85, P = .01), and similar relapse-free survival (P = .2). Loss of sex chromosomes (LOS) in addition to t(8;21) had a negative impact on overall survival (OS) in patients receiving chemotherapy. Patients without LOS experienced shorter survival after HCT comparing to chemotherapy (RR 3.05, P = .02), whereas patients with LOS had similar survival regardless of postremission therapy. In both cohorts, white blood cell count (WBC) at diagnosis >25 x 10(9)/L was associated with a higher relapse risk (RR = 2.09, P = .03), lower relapse-free (RR = 1.9, P = .008), and OS (RR = 1.91, P = .01). In this cohort of patients with t(8;21) AML, HCT did not improve OS, because reduction of relapse was offset by high TRM. In the group without LOS, survival after chemotherapy was far superior to HCT. These results suggest that patients with t(8;21) AML without poor prognostic factors have higher rates of survival after chemotherapy as a post remission therapy compared to HCT.
Authors: Richard F. Schlenk, Marcelo C. Pasquini, Waleska S. Pérez, Mei-Jie Zhang, Jürgen Krauter, Joseph H. Antin, Asad Bashey, Brian J. Bolwell, Thomas Büchner, Jean-Yves Cahn, Mitchell S. Cairo, Edward A. Copelan, Corey S. Cutler, Hartmut Döhner, Robert Peter Gale, Osman Ilhan, Hillard M. Lazarus, Jane L. Liesveld, Mark R. Litzow, David I. Marks, Richard T. Maziarz, Philip L. McCarthy, Stephen D. Nimer, Jorge Sierra, Martin S. Tallman, Daniel J. Weisdorf, Mary M. Horowitz, Arnold Ganser
Institutions: Universität Ulm, Medical College of Wisconsin, Medizinische Hochschule Hannover, Dana-Farber Cancer Institute, BMT Group (United States), Cleveland Clinic, University of Münster, Columbia University Irving Medical Center, Columbia University, Ankara University, University Hospitals of Cleveland, Case Western Reserve University, University of Rochester Medicine, University of Rochester, Mayo Clinic, Bristol Royal Hospital for Children, Oregon Health & Science University, Roswell Park Comprehensive Cancer Center, Memorial Sloan Kettering Cancer Center, Universitat Autònoma de Barcelona, Hospital de Sant Pau, Northwestern University, University of Minnesota
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,650
Funders: U.S. Department of Defense, U.S. Department of Health and Human Services, Abbott Laboratories, Amgen, Pfizer, Astellas Pharma US, GlaxoSmithKline, WellPoint, Baxter International, American International Group, Biogen, Celgene, Enzon Pharmaceuticals, HistoGenetics, Osiris Therapeutics, Therakos, Blue Cross and Blue Shield Association, StemCyte, Medical College of Wisconsin, Leuka, CellGenix, IC Design Education Center, Astellas Pharma, National Institutes of Health, U.S. Navy, Takeda Oncology, Office of Naval Research, National Cancer Institute, National Institute of Allergy and Infectious Diseases
OpenAlex ID: W2016231313