TY - JOUR
T1 - Hematologic Recovery after Pretransplant Chemotherapy Does Not Influence Survival after Allogeneic Hematopoietic Cell Transplantation in Acute Myeloid Leukemia Patients
AU - Vu, Khoan
AU - Manjappa, Shivaprasad
AU - DiPersio, John F.
AU - Gao, Feng
AU - Westervelt, Peter
AU - Vij, Ravi
AU - Stockerl-Goldstein, Keith E.
AU - Uy, Geoffrey L.
AU - Abboud, Camille N.
AU - Schroeder, Mark A.
AU - Fehniger, Todd A.
AU - Cashen, Amanda F.
AU - Romee, Rizwan
N1 - Publisher Copyright:
© 2015 American Society for Blood and Marrow Transplantation.
PY - 2015/8/1
Y1 - 2015/8/1
N2 - Pretransplant remission status in patients with acute myeloid leukemia (AML) is 1 of the most important factors determining their outcomes after allogeneic hematopoietic cell transplantation (allo-HCT). Most patients are in complete remission with full hematologic recovery (CR) before undergoing allo-HCT. However, some patients achieve CR without recovery of platelet count (CRp) or a morphologic leukemia-free state (MLFS), defined as meeting all CR criteria without recovery of both neutrophil and platelet counts. Currently, there is a paucity of data regarding transplant outcomes in AML patients achieving MLFS after chemotherapy. To address this question, we evaluated transplant outcomes in 270 AML patients who received 6/6 HLA-matched sibling or 10/10 HLA-matched unrelated donor transplantation at a single institution between 2006 and 2013. Of our 270 patients, 206 were in CR, 45 were in CRp, and 19 were in MLFS before allo-HCT. Patients in CR, CRp, or MLFS had similar 3-year overall survival rates (49%, 46%, and 47%, respectively; P= 88) and 3-year event-free survival rates (45%, 36%, and 40%, respectively; P= 53). However, the cumulative incidence of nonrelapse mortality was significantly higher in patients in MLFS compared with those in CR (58% versus 22%, P=.0004), whereas the cumulative incidence of relapse in patients in MLFS was significantly lower compared with those in CR (11% versus 36%, P=.03). Our results suggest that survival outcomes in AML patients are not influenced by degree of hematologic recovery before allo-HCT.
AB - Pretransplant remission status in patients with acute myeloid leukemia (AML) is 1 of the most important factors determining their outcomes after allogeneic hematopoietic cell transplantation (allo-HCT). Most patients are in complete remission with full hematologic recovery (CR) before undergoing allo-HCT. However, some patients achieve CR without recovery of platelet count (CRp) or a morphologic leukemia-free state (MLFS), defined as meeting all CR criteria without recovery of both neutrophil and platelet counts. Currently, there is a paucity of data regarding transplant outcomes in AML patients achieving MLFS after chemotherapy. To address this question, we evaluated transplant outcomes in 270 AML patients who received 6/6 HLA-matched sibling or 10/10 HLA-matched unrelated donor transplantation at a single institution between 2006 and 2013. Of our 270 patients, 206 were in CR, 45 were in CRp, and 19 were in MLFS before allo-HCT. Patients in CR, CRp, or MLFS had similar 3-year overall survival rates (49%, 46%, and 47%, respectively; P= 88) and 3-year event-free survival rates (45%, 36%, and 40%, respectively; P= 53). However, the cumulative incidence of nonrelapse mortality was significantly higher in patients in MLFS compared with those in CR (58% versus 22%, P=.0004), whereas the cumulative incidence of relapse in patients in MLFS was significantly lower compared with those in CR (11% versus 36%, P=.03). Our results suggest that survival outcomes in AML patients are not influenced by degree of hematologic recovery before allo-HCT.
KW - AML
KW - Complete remission
KW - Hematologic recovery
KW - Morphologic leukemia-free state
KW - Pretransplantation remission status
KW - Transplantation
UR - http://www.scopus.com/inward/record.url?scp=84937731983&partnerID=8YFLogxK
U2 - 10.1016/j.bbmt.2015.03.022
DO - 10.1016/j.bbmt.2015.03.022
M3 - Article
C2 - 25840336
AN - SCOPUS:84937731983
SN - 1083-8791
VL - 21
SP - 1425
EP - 1430
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 8
ER -