Outcomes of older patients aged 60 to 70 years undergoing reduced intensity transplant for acute myeloblastic leukemia: results of the NCRI acute myeloid leukemia 16 trial
Autor: | Ian Thomas, Charles Craddock, Michael Dennis, Richard E. Clark, Sylvie D. Freeman, Lars Kjeldsen, Abin Thomas, Nigel H. Russell, Alan Kenneth Burnett, Robert Kerrin Hills |
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Rok vydání: | 2021 |
Předmět: |
Adult
Male medicine.medical_specialty Transplantation Conditioning Acute myeloblastic leukemia medicine.medical_treatment Graft vs Host Disease Older patients hemic and lymphatic diseases Internal medicine Humans Medicine Sibling Aged Retrospective Studies Chemotherapy business.industry Hematopoietic Stem Cell Transplantation Cytogenetics Myeloid leukemia Reduced intensity Hematology Middle Aged medicine.disease Survival Analysis Transplantation Leukemia Myeloid Acute Female business |
Zdroj: | Haematologica. 107:1518-1527 |
ISSN: | 1592-8721 0390-6078 |
Popis: | Reduced intensity conditioning (RIC) transplantation is increasingly offered to older patients with acute myeloblastic leukemia. We have previously shown that a RIC allograft, particularly from a sibling donor, is beneficial in intermediate-risk patients aged 35-65 years. We here present analyses from the NCRI AML16 trial extending this experience to older patients aged 60-70 inclusive lacking favorable-risk cytogenetics. Nine hundred thirty-two patients were studied, with RIC transplant in first remission given to 144 (sibling n=52, matched unrelated donor n=92) with a median follow-up for survival from complete remission of 60 months. Comparisons of outcomes of patients transplanted versus those not were carried out using Mantel-Byar analysis. Among the 144 allografted patients, 93 had intermediate-risk cytogenetics, 18 had adverse risk and cytogenetic risk group was unknown for 33. In transplanted patients survival was 37% at 5 years, and while the survival for recipients of grafts from siblings (44%) was better than that for recipients of grafts from matched unrelated donors (34%), this difference was not statistically significant (P=0.2). When comparing RIC versus chemotherapy, survival of patients treated with the former was significantly improved (37% versus 20%, hazard ratio = 0.67 [0.53-0.84]; P |
Databáze: | OpenAIRE |
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