1. Early matched sibling hematopoietic cell transplantation for adult AML in first remission using an age-adapted strategy: long-term results of a prospective GOELAMS study.
- Author
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Lioure, Bruno, Béné, Marie C., Pigneux, Arnaud, Huynh, Anne, Chevallier, Patrice, Fegueux, Nathalie, Blaise, Didier, Witz, Brigitte, Delain, Martine, Comillon, Jérôme, Luquet, Isabelle, Blanchet, Odile, Comillet-Lefebvre, Pascale, Carré, Martin, Hunault, Mathilde, Larosa, Fabrice, Lamy, Thierry, Randriamalala, Edouard, Ojeda-Uribe, Mario, and Berthou, Christian
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HEMATOPOIETIC stem cell transplantation , *ACUTE myeloid leukemia , *HOMOGRAFTS , *MEDICAL statistics , *SIBLINGS , *HISTOCOMPATIBILITY testing , *PATIENTS - Abstract
The LAM2001 phase 3 trial, involving 832 patients with acute myeloid leukemia (AML; median: 46 years) proposed HLAidentical sibling allograft HSCT for all patients with an identified donor. The trial compared reduced-intensity conditioning (RIC) for patients older than 50 years of age (N = 47) and myeloablative conditioning for younger patients (N = 117). BM HSCT was performed in the younger patients, while the older ones received a consolidation course, followed by peripheral blood allo-HSCT using RIC. The incidence of grade ll-IV acute GVHD, was 51.9% (95% confidence interval [CI]: 42.1- 61.8) and 11.3% (1.6-21.2) after myeloablative or RIC, respectively (P < .0001) and that of chronic GVHD 45.8% (95% CI: 34.8-56.7) and 41.7% (24.7-58.6; NS). Cumulative incidence of nonrelapse mortality at 108 months was 15.8% (95% CI: 9.8-23.2) for myeloablative, and 6.5% (0.2- 16.2) for RIC (NS). CI of relapse at 108 months was 21.7% (95% CI: 13.9-28.6) and 28.6% (16.5-43.4; NS). Overall survival at 108 months was 63.4% (95% CI: 54.6-72.2) and 65.8% (52.2-72.2), respectively, after myeloablative or RIC (NS). RIC peripheral blood stem cell allo- HSCT is prospectively feasible for patients between the ages of 51 and 60 years without excess of relapse or nonrelapse mortality, and compares favorably with myeloablative marrow allo- HSCT proposed to younger patients. This study was registered at clinicaltrials. [ABSTRACT FROM AUTHOR]
- Published
- 2012
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