1. Early related or unrelated haematopoietic cell transplantation results in higher overall survival and leukaemia-free survival compared with conventional chemotherapy in high-risk acute myeloid leukaemia patients in first complete remission
- Author
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Norma Peter, Hans-Joerg Fricke, Nadezda Basara, Herbert G. Sayer, F. Kamprad, Constanze Kliem, R. Krahl, A. Gerhardt, Haifa Kathrin Al-Ali, Simone Heyn, Christian Junghanss, Cornelia Becker, Antje Schulze, Wolfram Pönisch, Thoralf Lange, Dietger Niederwieser, Martin Mohren, Ulrich Wedding, and Gottfried Dölken
- Subjects
Adult ,Male ,Cancer Research ,medicine.medical_specialty ,Myeloid ,Adolescent ,medicine.medical_treatment ,Hematopoietic stem cell transplantation ,Gastroenterology ,Disease-Free Survival ,Young Adult ,Recurrence ,hemic and lymphatic diseases ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,Medicine ,Humans ,Transplantation, Homologous ,Survival rate ,Chemotherapy ,business.industry ,Remission Induction ,Hematopoietic Stem Cell Transplantation ,Induction chemotherapy ,Consolidation Chemotherapy ,Hematology ,Middle Aged ,medicine.disease ,Surgery ,Transplantation ,Survival Rate ,Leukemia ,Leukemia, Myeloid, Acute ,medicine.anatomical_structure ,Oncology ,Karyotyping ,Female ,business - Abstract
Between 1996 and 2004, a total of 708 patients were enrolled in the acute myeloid leukaemia (AML) '96 and '02 studies of the East German Study Group (OSHO). Of these, 138 patients (19.5%) had unfavourable cytogenetics defined as complex karyotype, del (5q)/-5, del (7q)/-7, abn (3q26) and abn (11q23). In all, 77 (56%) achieved complete remission 1 (CR1) after induction chemotherapy and were eligible for haematopoietic cell transplantation (HCT). HCT was performed after a median of two cycles of consolidation chemotherapy (CT) in the AML '96 and one cycle in the AML '02 study (P=0.03). After a median follow-up of 19 months, overall survival (OS) at two years was significantly better in the donor group (52+/-9%) versus the no-donor group (24+/-8%; P=0.005). Differences in outcomes were mainly because of a lower relapse incidence in patients after HCT (39+/-11%) compared with a higher relapse incidence in patients undergoing CT (77+/-10%; P=0.0005). Treatment-related mortality was low and not statistically significantly different between the two treatment groups (15+/-7 and 5+/-5% for HCT and chemotherapy, respectively; P=0.49).We conclude that early HCT from related or unrelated donors led to significantly better OS and leukaemia-free survival compared with chemotherapy in patients with unfavourable karyotype.
- Published
- 2009