Improved Outcome for AML Relapse after Allogeneic Transplant with High Intensity Chemotherapy Followed By 2nd Allogeneic Stem Cell Transplant or Donor Lymphocyte Infusion; A Retrospective Analysis
| Autor: | Baldeep Wirk, Brooke Silar, Shin Mineishi, David F. Claxton, Kentaro Minagawa, Hong Zheng, Witold B. Rybka, Robert J. Greiner, Neal Shah, Joseph Mierski, Kevin Rakszawski, Seema Naik, Valerie I. Brown, W. Christopher Ehmann, Myles Nickolich, Gina Mackey |
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| Rok vydání: | 2020 |
| Předmět: |
Oncology
Transplantation medicine.medical_specialty Chemotherapy business.industry medicine.medical_treatment Cancer Myeloid leukemia ECOG Performance Status Hematology medicine.disease Donor lymphocyte infusion Log-rank test surgical procedures operative immune system diseases hemic and lymphatic diseases Internal medicine medicine Stem cell business human activities therapeutics Survival analysis |
| Zdroj: | Biology of Blood and Marrow Transplantation. 26:S99-S100 |
| ISSN: | 1083-8791 |
| DOI: | 10.1016/j.bbmt.2019.12.601 |
| Popis: | Background Acute myeloid leukemia (AML) relapse after allogeneic stem cell transplant (allo SCT) remains a major therapeutic challenge. While patients with longer remission after initial allo SCT are recommended to receive either 2nd allo SCT or donor lymphocyte infusion (2nd allo SCT/DLI), survival probability for patients relapsing within 6 months of SCT are dismal. We evaluated the outcomes of AML relapse after allo SCT to assess the impact of 2nd allo SCT/DLI on long term survival. Methods and Results One hundred and seventy-two patients with AML underwent allo SCT at Penn State Cancer Institute from Jan 2014 to Aug 2019. Sixty-nine patients relapsed after allo SCT (median age, 60 years; range, 10-75). Of these, 4 patients underwent 2nd allo SCT and 26 received DLI. Overall survival (OS) was defined as days from the relapse and evaluated with Kaplan-Meier survival curves and log rank tests. One-year OS in all cases was 22.4% (95% CI: 13.3-32.9%). Patients with ECOG performance status (PS) 0-2 at relapse (n=60) showed a better 1-year OS compared to those with ECOG PS 3-4 (n=9) (24 vs 11.1%, p Conclusions Relapsed AML after allo SCT treated with high intensity chemotherapy followed by 2nd allo SCT/DLI showed a better OS. Similar benefit was shown even for patients who relapsed within 6 months of allo SCT. |
| Databáze: | OpenAIRE |
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