TY - JOUR
T1 - Hematopoietic stem cell transplantation for adults with relapsed acute promyelocytic leukemia in second complete remission
AU - Acute Leukemia Working Party of the European society for Blood and Marrow Transplantation (EBMT)
AU - Sanz, Jaime
AU - Labopin, Myriam
AU - Sanz, Miguel A.
AU - Aljurf, Mahmoud
AU - Sousa, Aida Botelho
AU - Craddock, Charles
AU - Zuckerman, Tsila
AU - Labussière-Wallet, Hélène
AU - Campos, Antonio
AU - Grillo, Giovanni
AU - Ozkurt, Zubeyde Nur
AU - Cornelissen, J. J.
AU - Reményi, Péter
AU - Martino, Massimo
AU - Porras, Rocio Parody
AU - Nagler, Arnon
AU - Gorin, Norbert Claude
AU - Mohty, Mohamad
N1 - Publisher Copyright:
© 2020, The Author(s), under exclusive licence to Springer Nature Limited.
PY - 2021/6
Y1 - 2021/6
N2 - We retrospectively compared outcomes of a large series of adult patients with APL in CR2 receiving alloHSCT (n = 228) or autoHSCT (n = 341) reported to the European Society for Blood and Marrow Transplantation from January 2004 to December 2018. The 2-year cumulative incidence of non-relapse mortality was significantly higher for alloHSCT 17.3% (95% CI 12.5–22.8) compared with autoHSCT 2.7% (95% CI 1.2–5) (p = 0.001), while differences in relapse rate were not significant (28% versus 22.9%; p = 0.28). Leukemia-free survival (LFS) and overall survival (OS) favored autoHSCT with 74.5% (95% CI 69–79.2) and 82.4% (95% CI 77.3–86.5) compared with alloHSCT with 54.7% (95% CI 47.5–61.3) (p = 0.001) and 64.3% (95% CI 57.2–70.6), respectively (p = 0.001 and p = 0.001). Multivariable analysis showed significantly worse LFS after alloHSCT (HR 0.49; 95% CI 0.37–0.67; p < 0.0001), older age (p = 0.001), and shorter time from diagnosis to transplant (p = 0.00015). Similar results were obtained for OS. The study shows that autoHSCT resulted in better survival outcomes (LFS and OS) for APL in CR2. These results were mainly due to reduced NRM in the autoHSCT as compared to alloHSCT.
AB - We retrospectively compared outcomes of a large series of adult patients with APL in CR2 receiving alloHSCT (n = 228) or autoHSCT (n = 341) reported to the European Society for Blood and Marrow Transplantation from January 2004 to December 2018. The 2-year cumulative incidence of non-relapse mortality was significantly higher for alloHSCT 17.3% (95% CI 12.5–22.8) compared with autoHSCT 2.7% (95% CI 1.2–5) (p = 0.001), while differences in relapse rate were not significant (28% versus 22.9%; p = 0.28). Leukemia-free survival (LFS) and overall survival (OS) favored autoHSCT with 74.5% (95% CI 69–79.2) and 82.4% (95% CI 77.3–86.5) compared with alloHSCT with 54.7% (95% CI 47.5–61.3) (p = 0.001) and 64.3% (95% CI 57.2–70.6), respectively (p = 0.001 and p = 0.001). Multivariable analysis showed significantly worse LFS after alloHSCT (HR 0.49; 95% CI 0.37–0.67; p < 0.0001), older age (p = 0.001), and shorter time from diagnosis to transplant (p = 0.00015). Similar results were obtained for OS. The study shows that autoHSCT resulted in better survival outcomes (LFS and OS) for APL in CR2. These results were mainly due to reduced NRM in the autoHSCT as compared to alloHSCT.
UR - http://www.scopus.com/inward/record.url?scp=85097594647&partnerID=8YFLogxK
U2 - 10.1038/s41409-020-01162-0
DO - 10.1038/s41409-020-01162-0
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C2 - 33323947
AN - SCOPUS:85097594647
SN - 0268-3369
VL - 56
SP - 1272
EP - 1280
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
IS - 6
ER -
