EARLY HEMATOPOIETIC CELL TRANSPLANTATION RESULTS IN HIGHER OVERALL SURVIVAL AND LEUKEMIA FREE SURVIVAL COMPARED TO CONVENTIONAL CHEMOTHERAPY IN HIGH RISK ACUTE MYELOID LEUKAEMIA (AML) PATIENTS
Journal Title: Acta Facultatis Medicae Naissensis - Year 2011, Vol 28, Issue 4
Abstract
Between 1996 and 2004, a total of 708 patients were enrolled in the AML ´96 and 2002 studies of the East German Study Group. Of those, 138 patients (19.5%) had unfavourable cytogenetics defined as complex karyotype, del (5q)/-5, del (7q)/-7, abn (3q26) and abn (11q23). Seventy-seven (56%) patients achieved CR1 after induction chemotherapy and were eligible for HCT. HCT was performed after a median of two cycles of consolidation chemotherapies in the AML ´96 and one cycle in the AML 2002 (p=0.03). After a median follow-up of 21 months, OS amounted 73±14%, 50±14% and 14±8% at 3 years for patients after related HCT, unrelated HCT and chemotherapy, respectively (p=.008). Differences in outcomes were mainly due to a lower relapse incidence (26±13% for related and 48±15% for unrelated HCT) in patients after HCT compared to a higher relapse incidence in patients undergoing consolidation chemotherapy (89±8%; p=.003). Treatment-related mortality was low and not statistically significantly different between the three treatment groups (10±9%, 14±10% and 6± 6% for related, unrelated and chemotherapy; p=0.98). We conclude that early HCT from related or unrelated donors led to significantly better OS and LFS compared to chemotherapy in patients with unfavourable karyotype.
Authors and Affiliations
Nadežda Basara, Antje Schulze, Herbert Sayer
Keywords
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