NYMC Faculty Publications

Unrelated Donor Allogeneic Transplantation After Failure of Autologous Transplantation for Acute Myelogenous Leukemia: A Study From the Center for International Blood and Marrow Transplantation Research

Author Type(s)

Faculty

DOI

10.1016/j.bbmt.2013.04.022

Journal Title

Biology of Blood and Marrow Transplantation: Journal of the American Society for Blood and Marrow Transplantation

First Page

1102

Last Page

1108

Document Type

Article

Publication Date

7-1-2013

Keywords

Adolescent, Adult, Aged, Antineoplastic Agents, Child, Child, Preschool, Female, Follow-Up Studies, Graft vs Host Disease, Hematopoietic Stem Cell Transplantation, Humans, Infant, International Cooperation, Leukemia, Myeloid, Acute, Male, Middle Aged, Recurrence, Survival Analysis, Transplantation Conditioning, Transplantation, Autologous, Transplantation, Homologous, Unrelated Donors

Disciplines

Medicine and Health Sciences

Abstract

The survival of patients with relapsed acute myelogenous leukemia (AML) after autologous hematopoietic stem cell transplantation (auto-HCT) is very poor. We studied the outcomes of 302 patients who underwent secondary allogeneic hematopoietic cell transplantation (allo-HCT) from an unrelated donor (URD) using either myeloablative (n = 242) or reduced-intensity conditioning (RIC; n = 60) regimens reported to the Center for International Blood and Marrow Transplantation Research. After a median follow-up of 58 months (range, 2 to 160 months), the probability of treatment-related mortality was 44% (95% confidence interval [CI], 38%-50%) at 1-year. The 5-year incidence of relapse was 32% (95% CI, 27%-38%), and that of overall survival was 22% (95% CI, 18%-27%). Multivariate analysis revealed a significantly better overal survival with RIC regimens (hazard ratio [HR], 0.51; 95% CI, 0.35-0.75; P18 months) from auto-HCT to URD allo-HCT was associated with significantly lower riak of relapse (HR, 0.19; 95% CI, 0.09-0.38; P

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