Allogeneic stem cell transplantation versus chemotherapy as post-remission therapy for intermediate or poor risk adult acute myeloid leukemia: results of the JALSG AML97 study

Autor: Shin Matsuda, Masatomo Takahashi, Yuji Kishimoto, Yasushi Miyazaki, Ryuzo Ohno, Kinuko Mitani, Nobuhiko Emi, Norio Asou, Shigeki Ohtake, Fumiharu Yagasaki, Sumihisa Honda, Shuichi Miyawaki, Hisashi Sakamaki, Yoshiaki Ogawa
Rok vydání: 2010
Předmět:
Zdroj: International Journal of Hematology. 91:284-292
ISSN: 1865-3774
0925-5710
DOI: 10.1007/s12185-009-0483-2
Popis: We prospectively compared allogeneic hematopoietic stem cell transplantation (allo-HSCT) with chemotherapy as a post-remission therapy in a multicenter trial (JALSG AML97) of adult patients with intermediate or poor risk acute myeloid leukemia (AML). Of 503 patients aged 15-50 years old registered between December 1997 and July 2001, 392 achieved complete remission (CR). CR patients classified in the intermediate or poor risk group using a new scoring system were tissue typed. Seventy-three with and 92 without an HLA-identical sibling were assigned to the donor and no-donor groups. Of 73 patients in the donor group, 38 (52%) received allo-HSCT during CR1 and 17 (23%) after relapse. Intention-to-treat analysis revealed that the relapse incidence was reduced in the donor group (52 vs. 77%; p = 0.008), and the disease-free survival (DFS) improved (39 vs. 19%; p = 0.016), but overall survival (OS) was not significantly different (46 vs. 29%; p = 0.088). The OS benefit was seen in the patients aged 36-50 years old (49 vs. 24%; p = 0.031), suggesting an advantage of allo-HSCT among older patients with leukemia that is more resistant to chemotherapy than that among younger patients.
Databáze: OpenAIRE
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