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Impact of pre-transplant induction and consolidation cycles on AML allogeneic transplant outcomes: a CIBMTR analysis in 3113 AML patients.

Authors :
Boyiadzis M
Zhang MJ
Chen K
Abdel-Azim H
Abid MB
Aljurf M
Bacher U
Badar T
Badawy SM
Battiwalla M
Bejanyan N
Bhatt VR
Brown VI
Castillo P
Cerny J
Copelan EA
Craddock C
Dholaria B
Perez MAD
Ebens CL
Gale RP
Ganguly S
Gowda L
Grunwald MR
Hashmi S
Hildebrandt GC
Iqbal M
Jamy O
Kharfan-Dabaja MA
Khera N
Lazarus HM
Lin R
Modi D
Nathan S
Nishihori T
Patel SS
Pawarode A
Saber W
Sharma A
Solh M
Wagner JL
Wang T
Williams KM
Winestone LE
Wirk B
Zeidan A
Hourigan CS
Litzow M
Kebriaei P
de Lima M
Page K
Weisdorf DJ
Source :
Leukemia [Leukemia] 2023 May; Vol. 37 (5), pp. 1006-1017. Date of Electronic Publication: 2022 Oct 30.
Publication Year :
2023

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.<br /> (© 2022. The Author(s), under exclusive licence to Springer Nature Limited.)

Details

Language :
English
ISSN :
1476-5551
Volume :
37
Issue :
5
Database :
MEDLINE
Journal :
Leukemia
Publication Type :
Academic Journal
Accession number :
36310182
Full Text :
https://doi.org/10.1038/s41375-022-01738-3