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Central Nervous System Involvement at the Time of Allogeneic Hematopoietic Stem Cell Transplantation Is Associated with a Poor Outcome in Patients with Acute Myeloid Leukemia.
- Source :
-
Pathology oncology research : POR [Pathol Oncol Res] 2017 Apr; Vol. 23 (2), pp. 433-437. Date of Electronic Publication: 2016 Dec 21. - Publication Year :
- 2017
-
Abstract
- Recent reports suggested that central nervous system (CNS) involvement (CNS+) in patients with acute myeloid leukemia (AML) before allogeneic hematopoietic stem cell transplantation (allo-HSCT) is not an independent predictor of survival after allo-HSCT. However, these studies did not analyze minimal residual disease in the CNS at the time of allo-HSCT. We evaluated the effect of residual CNS+ on the transplant outcomes of 214 AML patients in a single institution. Twenty-one (10%) patients were diagnosed with CNS+ prior to allo-HSCT. Of these, 13 patients had CNS disease at the time of allo-HSCT. The patients in CNS+ AML remission at the time of allo-HSCT had better overall survival (OS) than the patients who were not in remission (2-year OS: 55% vs. 7.7%, p = 0.0001). In multivariate analyses, CNS+ at the time of allo-HSCT (hazard ratio (HR), 1.9; 95% confidence interval (CI), 1.05-3.59; p = 0.04), age over 50 years at the time of allo-HSCT, and non-complete remission disease status in bone marrow at the time of allo-HSCT were independent adverse factors for OS. However, a prior history of CNS+ before allo-HSCT did not independently affect OS (HR, 1.27; 95% CI 0.53-2.07; p = 0.6). Early diagnosis and eradication of CNS+ at the time of allo-HSCT may be necessary to improve the outcome for patients with CNS+ AML.
- Subjects :
- Acute Disease
Adolescent
Adult
Aged
Bone Marrow pathology
Female
Humans
Male
Middle Aged
Neoplasm, Residual pathology
Remission Induction
Young Adult
Central Nervous System Neoplasms genetics
Central Nervous System Neoplasms pathology
Hematopoietic Stem Cell Transplantation adverse effects
Leukemia, Myeloid, Acute pathology
Transplantation, Homologous adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1532-2807
- Volume :
- 23
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Pathology oncology research : POR
- Publication Type :
- Academic Journal
- Accession number :
- 28004352
- Full Text :
- https://doi.org/10.1007/s12253-016-0162-6