The outcome of allogeneic HSCT in older AML patients is determined by disease biology and not by the donor type: An analysis of 96 allografted AML patients ≥50 years from the Czech acute leukaemia clinical register (alert)
| Autor: | Michal Karas, Luděk Raida, Karel Indrak, Vladimir Koza, Tomáš Szotkowski, Petr Cetkovsky, F. A. Sabty, Tomas Kozak, Pavel Jindra, Jan Mužík, Pavel Zak |
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| Rok vydání: | 2013 |
| Předmět: |
Male
Cancer Research medicine.medical_specialty Pediatrics Poor prognosis Multivariate analysis medicine.medical_treatment Kaplan-Meier Estimate Disease Disease-Free Survival Internal medicine medicine Humans Transplantation Homologous Registries Aged Proportional Hazards Models Retrospective Studies Chemotherapy business.industry Hematopoietic Stem Cell Transplantation Cytogenetics Retrospective cohort study Middle Aged Tissue Donors Czechoslovakia Transplantation Leukemia Myeloid Acute Treatment Outcome Oncology Allogeneic hsct Female business |
| Zdroj: | Neoplasma. 60:576-583 |
| ISSN: | 1338-4317 |
| DOI: | 10.4149/neo_2013_075 |
| Popis: | Older patients with AML have poor prognosis after chemotherapy and allo-SCT was historically limited to the young patients. In the multicentre retrospective study we analyzed 96 consecutive AML patients >= 50 years allografted with related (n=59) or unrelated (n=37) donor. The 2- year OS and DFS rates were 45 % and 42 % for the whole group. The corresponding figures for related patients were 48% and 42% whereas for unrelated 42% and 42%, respectively (OS p=0,721, DFS p = 0,896). The cumulative incidences of relapse (28% of all patients) and NRM mortality (26%) were low with no significant differences among related and unrelated cohorts. Multivariate analysis revealed the only major independent variables associated with an inferior OS were unfavourable cytogenetics (RR 3.36; CI 1.66-6.83; p=0.001) and advanced disease status (RR 2.30; CI 1.21-4.37; p=0.011). Unfavourable cytogenetics (RR 3.00; CI 1.50-5.99; p=0.002) and advanced disease at SCT (RR 2.27; CI 1.22-4.22; p=0.009) were also the only independent variables associated with inferior DFS. In conclusion, our analysis indicates that outcomes of allografted AML patients aged >= 50 years are determined by cytogenetic risk category and disease status at transplantation and not by the type of donor. |
| Databáze: | OpenAIRE |
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