Trends in allogeneic transplantation for favorable risk acute myeloid leukemia in first remission: a longitudinal study of >15 years from the ALWP of the EBMT.

Autor: Nagler A; Division of Hematology, Sheba Medical Center, Tel Hashomer, Israel. arnon.nagler@sheba.health.gov.il., Labopin M; EBMT Paris study office; Department of Haematology, Saint Antoine Hospital; INSERM UMR 938, Sorbonne University, Paris, France.; Sorbonne University, Department of Haematology, Saint Antoine Hospital; INSERM UMR 938, Paris, France., Salmenniemi U; HUCH Comprehensive Cancer Center, Helsinki, Finland., Wu D; First Affiliated Hospital of Soochow University, Suzhou, China., Blaise D; Programme de Transplantation & Therapie Cellulaire, Marseille, France., Rambaldi A; Department of Oncology and Hematology, University of Milan and Azienda Socio-Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy., Reményi P; Dél-pesti Centrumkórház, Budapest, Hungary., Forcade E; CHU Bordeaux, Hopital Haut-L'évêque, Pessac, France., Socié G; University Paris Cité, INSERM UMR 976, APHP- Saint-Louis Hospital, BMT Unit, Paris, France., Chevallier P; CHU Nantes, Nantes, France., von dem Borne P; Leiden University Medical Center, Leiden, The Netherlands., Burns D; University Hospital Birmingham NHS Trust, Stoke, UK., Schmid C; Klinikum Augsburg, Augsburg, Germany., Maertens J; University Hospital Gasthuisberg, Leuven, Belgium., Kröger N; University Medical Center Hamburg, Hamburg, Germany., Bug G; Goethe-Universitaet, Frankfurt Main, Germany., Aljurf M; King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia., Vydra J; Institute of Hematology and Blood Transfusion, Prague, Czech Republic., Halaburda K; Institute of Hematology and Transfusion Medicine, Warsaw, Poland., Ciceri F; IRCCS Osspedale San Raffaele, Vita-Salute San Raffaele University Haematology and BMT, Milano, Italy., Mohty M; EBMT Paris study office; Department of Haematology, Saint Antoine Hospital; INSERM UMR 938, Sorbonne University, Paris, France.; Sorbonne University, Department of Haematology, Saint Antoine Hospital; INSERM UMR 938, Paris, France.
Jazyk: angličtina
Zdroj: Bone marrow transplantation [Bone Marrow Transplant] 2024 Nov; Vol. 59 (11), pp. 1563-1576. Date of Electronic Publication: 2024 Aug 20.
DOI: 10.1038/s41409-024-02379-z
Abstrakt: We assessed outcomes of allogeneic transplantation (HSCT) in favorable risk AML in CR1 over 3 time periods. 1850 patients were included, 2005 to 2009- 222, 2010 to 2014 -392, and 2015 to 2021-1236; 526 with t (8:21), 625 with inv (16), and 699 with NPM1 mut FLT3 WT . Patients transplanted in 2015-2021 were older (p < 0.0001) with more patients ≥60 years of age (p < 0.0001). The most frequent diagnosis in 2015-2021 was NPM1 mut FLT3 WT vs. t (8:21) in the 2 earlier periods, (p < 0001). Haploidentical transplants (Haplo) increased from 5.9% to 14.5% (p < 0.0001). Graft-versus-host disease (GVHD) prophylaxis with post-transplant cyclophosphamide (PTCy) was more frequent in 2015-2021 vs. the other 2 periods (p < 0.0001). On multivariate analysis, incidence of total chronic GVHD was reduced in HSCTs performed ≥2015 vs. those performed in 2005-2009, hazard ratio (HR) = 0.74 (95% CI 0.56-0.99, p = 0.046) and GVHD-free, relapse-free survival (GRFS) improved for patients transplanted from 2010-2014 vs. those transplanted in 2005-2009, HR = 0.74 (95% CI 0.56-0.98, p = 0.037). Other HSCT outcomes did not differ with no improvement ≥2015. LFS, OS, and GRFS were inferior in patients with t (8:21) with HR = 1.32 (95% CI 1.03-1.68, p = 0.026), HR = 1.38 (95% CI 1.04-1.83, p = 0.027) and HR = 01.25 (95% CI 1.02-1.53, p = 0.035), respectively. In conclusion, this retrospective analysis of HSCT in patients with favorable risk AML, transplanted over 16 years showed an increased number of transplants in patients ≥60 years, from Haplo donors with PTCy. Most importantly, 3-year GRFS improved ≥2010 and total chronic GVHD reduced ≥2015, with no significant change in other HSCT outcomes.
(© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)
Databáze: MEDLINE
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