1. Impact of pre-transplant induction and consolidation cycles on AML allogeneic transplant outcomes: a CIBMTR analysis in 3113 AML patients.
- Author
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Boyiadzis, Michael, Zhang, Mei-Jie, Chen, Karen, Abdel-Azim, Hisham, Abid, Muhammad, Aljurf, Mahmoud, Bacher, Ulrike, Badar, Talha, Badawy, Sherif, Battiwalla, Minoo, Bejanyan, Nelli, Bhatt, Vijaya, Brown, Valerie, Castillo, Paul, Cerny, Jan, Copelan, Edward, Craddock, Charles, Dholaria, Bhagirathbhai, Perez, Miguel, Ebens, Christen, Gale, Robert, Ganguly, Siddhartha, Gowda, Lohith, Grunwald, Michael, Hashmi, Shahrukh, Hildebrandt, Gerhard, Iqbal, Madiha, Jamy, Omer, Kharfan-Dabaja, Mohamed, Khera, Nandita, Lazarus, Hillard, Lin, Richard, Modi, Dipenkumar, Nathan, Sunita, Nishihori, Taiga, Patel, Sagar, Pawarode, Attaphol, Saber, Wael, Sharma, Akshay, Solh, Melhem, Wagner, John, Wang, Trent, Williams, Kirsten, Wirk, Baldeep, Zeidan, Amer, Hourigan, Christopher, Litzow, Mark, Kebriaei, Partow, de Lima, Marcos, Page, Kristin, Weisdorf, Daniel, and Winestone, Lena
- Subjects
Adult ,Humans ,Transplantation ,Homologous ,Transplantation Conditioning ,Neoplasm Recurrence ,Local ,Hematopoietic Stem Cell Transplantation ,Leukemia ,Myeloid ,Acute ,Retrospective Studies - Abstract
We investigated the impact of the number of induction/consolidation cycles on outcomes of 3113 adult AML patients who received allogeneic hematopoietic cell transplantation (allo-HCT) between 2008 and 2019. Patients received allo-HCT using myeloablative (MAC) or reduced-intensity (RIC) conditioning in first complete remission (CR) or with primary induction failure (PIF). Patients who received MAC allo-HCT in CR after 1 induction cycle had 1.3-fold better overall survival (OS) than 2 cycles to CR and 1.47-fold better than ≥3 cycles. OS after CR in 2 or ≥3 cycles was similar. Relapse risk was 1.65-fold greater in patients receiving ≥3 cycles to achieve CR. After RIC allo-HCT, the number of induction cycles to CR did not affect OS. Compared to CR in 1 cycle, relapse risk was 1.24-1.41-fold greater in patients receiving 2 or ≥3 cycles. For patients receiving only 1 cycle to CR, consolidation therapy prior to MAC allo-HCT was associated with improved OS vs. no consolidation therapy. Detectable MRD at the time of MAC allo-HCT did not impact outcomes while detectable MRD preceding RIC allo-HCT was associated with an increased risk of relapse. For allo-HCT in PIF, OS was significantly worse than allo-HCT in CR after 1-3 cycles.
- Published
- 2023