TY - JOUR
T1 - Allogeneic hematopoietic cell transplantation for patients with AML aged 70 years or older in first remission. A study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation (EBMT)
AU - Maffini, Enrico
AU - Ngoya, Maud
AU - Galimard, Jacques Emmanuel
AU - Harbi, Samia
AU - Kröger, Nicolaus
AU - Platzbecker, Uwe
AU - Sengeloev, Henrik
AU - Craddock, Charles
AU - Potter, Victoria
AU - Choi, Goda
AU - Chevallier, Patrice
AU - Stölzel, Friedrich
AU - Tholouli, Eleni
AU - Maertens, Johan
AU - Ciceri, Fabio
AU - Cornelissen, Jan
AU - Sanz, Jaime
AU - Spyridonidis, Alexandros
AU - Lanza, Francesco
AU - Nagler, Arnon
AU - Mohty, Mohamad
N1 - Publisher Copyright:
© 2023, The Author(s), under exclusive licence to Springer Nature Limited.
PY - 2023/9
Y1 - 2023/9
N2 - Accessibility to allogeneic hematopoietic cell transplantation (HCT) programs for older patients is growing constantly. We report on the clinical outcomes of a group of 701 adults aged ≥70 years, with acute myeloid leukemia (AML) in first complete remission (CR1), who received a first HCT, from HLA-matched sibling donors (MSD), 10/10 HLA-matched unrelated donors (UD), 9/10 HLA-mismatched unrelated donors (mUD) or haploidentical (Haplo) donors. The 2-year overall survival (OS) was 48.1%, leukemia-free survival (LFS) 45.3%, relapse incidence (RI) 25.2%, non-relapse mortality (NRM) 29.5% and GVHD-free, relapse-free survival (GRFS), 33.4%. Compared to MSD, patients transplanted from Haplo and UD presented lower RI (HR 0.46, 95% CI 0.25–0.8, p = 0.02 and HR 0.44, 95% CI: 0.28–0.69, p = 0.001, respectively); this translated into prolonged LFS for Haplo (HR 0.62, 95% CI: 0.39–0.99, p = 0.04). Patients transplanted from mUD exhibited the highest NRM incidence (HR 2.33, 95% CI: 1.26–4.31, p = 0.007). HCT in selected adult CR1 AML patients >70 years is feasible and could be associated with good clinical outcomes. Prospective clinical trials are warranted.
AB - Accessibility to allogeneic hematopoietic cell transplantation (HCT) programs for older patients is growing constantly. We report on the clinical outcomes of a group of 701 adults aged ≥70 years, with acute myeloid leukemia (AML) in first complete remission (CR1), who received a first HCT, from HLA-matched sibling donors (MSD), 10/10 HLA-matched unrelated donors (UD), 9/10 HLA-mismatched unrelated donors (mUD) or haploidentical (Haplo) donors. The 2-year overall survival (OS) was 48.1%, leukemia-free survival (LFS) 45.3%, relapse incidence (RI) 25.2%, non-relapse mortality (NRM) 29.5% and GVHD-free, relapse-free survival (GRFS), 33.4%. Compared to MSD, patients transplanted from Haplo and UD presented lower RI (HR 0.46, 95% CI 0.25–0.8, p = 0.02 and HR 0.44, 95% CI: 0.28–0.69, p = 0.001, respectively); this translated into prolonged LFS for Haplo (HR 0.62, 95% CI: 0.39–0.99, p = 0.04). Patients transplanted from mUD exhibited the highest NRM incidence (HR 2.33, 95% CI: 1.26–4.31, p = 0.007). HCT in selected adult CR1 AML patients >70 years is feasible and could be associated with good clinical outcomes. Prospective clinical trials are warranted.
UR - http://www.scopus.com/inward/record.url?scp=85163596437&partnerID=8YFLogxK
U2 - 10.1038/s41409-023-02027-y
DO - 10.1038/s41409-023-02027-y
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C2 - 37386253
AN - SCOPUS:85163596437
SN - 0268-3369
VL - 58
SP - 1033
EP - 1041
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
IS - 9
ER -