HLA-Mismatched Microtransplant in Older Patients Newly Diagnosed With Acute Myeloid Leukemia: Results From the Microtransplantation Interest Group
| Autor: | Kai-Xun Hu, Jian-Hui Qiao, Hui-Sheng Ai, Bo Cai, Hong-Li Zuo, Anthony D. Sung, Lin-Hua Yang, Xuliang Shen, Wei-Wei Liu, Yang-Yi Bao, Wan-Jun Sun, Elizabeth F. Krakow, Depei Wu, Rafael Fores, Qi-Yun Sun, Xinrong Zhan, Li Liu, Ann Mohrbacher, David A. Rizzieri, Jian-Yong Li, Si-Xuan Qian, Nelson J. Chao, Juan Wang, Zhiqing Liu, Ya-Jing Huang, Zheng Dong, Bo Yao, Hong-Xia Zhao, Tie-Qiang Liu, Jun-Xiao Qiao, Chang-Lin Yu, Rafael F. Duarte, Min Zhou, Mei Guo |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Cancer Research
medicine.medical_specialty Myeloid business.industry Induction chemotherapy Myeloid leukemia medicine.disease Microtransplantation Surgery 03 medical and health sciences Leukemia 0302 clinical medicine medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis Internal medicine hemic and lymphatic diseases Clinical endpoint medicine Age of onset business Survival analysis 030215 immunology Original Investigation |
| Popis: | Importance The outcome of older patients with acute myeloid leukemia (AML) remains unsatisfactory. Recent studies have shown that HLA-mismatched microtransplant could improve outcomes in such patients. Objective To evaluate outcomes in different age groups among older patients with newly diagnosed AML who receive HLA-mismatched microtransplant. Design, Setting, and Participants This multicenter clinical study included 185 patients with de novo AML at 12 centers in China, the United States, and Spain in the Microtransplantation Interest Group. Patients were divided into the following 4 age groups: 60 to 64 years, 65 to 69 years, 70 to 74 years, and 75 to 85 years. The study period was May 1, 2006, to July 31, 2015. Exposures Induction chemotherapy and postremission therapy with cytarabine hydrochloride with or without anthracycline, followed by highly HLA-mismatched related or fully mismatched unrelated donor cell infusion. No graft-vs-host disease prophylaxis was used. Main Outcomes and Measures The primary end point of the study was to evaluate the complete remission rates, leukemia-free survival, and overall survival in different age groups. Additional end points of the study included hematopoietic recovery, graft-vs-host disease, relapse rate, nonrelapse mortality, and other treatment-related toxicities. Results Among 185 patients, the median age was 67 years (range, 60-85 years), and 75 (40.5%) were female. The denominators in adjusted percentages in overall survival, leukemia-free survival, relapse, and nonrelapse mortality are not the sample proportions of observations. The overall complete remission rate was not significantly different among the 4 age groups (75.4% [52 of 69], 70.2% [33 of 47], 79.1% [34 of 43], and 73.1% [19 of 26). The 1-year overall survival rates were 87.7%, 85.8%, and 77.8% in the first 3 age groups, which were much higher than the rate in the fourth age group (51.7%) ( P = .004, P = .008, and P = .04, respectively). The 2-year overall survival rates were 63.7% and 66.8% in the first 2 age groups, which were higher than the rates in the last 2 age groups (34.2% and 14.8%) ( P = .02, P = .03, P P Conclusions and Relevance Microtransplant achieved a high complete remission rate in AML patients aged 60 to 85 years and higher 1-year overall survival in those aged 60 to 74 years. |
| Databáze: | OpenAIRE |
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