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Pretransplantation MRD in Older Patients With AML After Treatment With Decitabine or Conventional Chemotherapy
- Source :
- Transplantation and cellular therapy, 27(3), 246-252, Transplantation and Cellular Therapy, 27, 3, pp. 246-252, Transplantation and Cellular Therapy, 27, 246-252
- Publication Year :
- 2020
-
Abstract
- The predictive value of measurable residual disease (MRD) for survival in acute myeloid leukemia (AML) has been firmly established in younger patients treated with intensive chemotherapy. The value of MRD after treatment with decitabine in older patients is unknown. This retrospective analysis included patients ≥60 years of age with AML who received an allogeneic hematopoietic cell transplantation (alloHCT) after treatment with decitabine or intensive chemotherapy. Of the 133 consecutively transplanted patients, 109 had available pretransplantation MRD analyses (by flowcytometry [threshold 0.1%]). Forty patients received decitabine treatment (10-day schedule), and 69 patients received intensive chemotherapy (7 + 3 regimen). Patients who received decitabine were older (median 67 versus 64 years) and more often had MRD (70% versus 38%). OS after alloHCT was comparable in both groups. In the chemotherapy group, MRD-positive patients had a significantly higher relapse probability (subdistribution hazard ratio [sHR] 4.81; P= .0031) and risk of death (HR 2.8; P= .02) compared to MRD-negative patients. In the decitabine group there was no significant association between the presence of MRD and relapse (sHR 0.85; P= .83) or death (HR 0.72; P= .60). Pretransplantation MRD in patients receiving decitabine treatment does not have similar predictive value for relapse or survival in older AML patients receiving an alloHCT, compared to patients receiving intensive chemotherapy.
- Subjects :
- Oncology
medicine.medical_specialty
Neoplasm, Residual
medicine.medical_treatment
ANTIGEN
Decitabine
MINIMAL RESIDUAL DISEASE
ACUTE MYELOID-LEUKEMIA
DIAGNOSIS
THERAPY
HEMATOPOIETIC-CELL TRANSPLANTATION
All institutes and research themes of the Radboud University Medical Center
Older patients
AML
Internal medicine
hemic and lymphatic diseases
medicine
Immunology and Allergy
Chemotherapy
Humans
Aged
Retrospective Studies
Transplantation
business.industry
Myeloid leukemia
Cell Biology
Hematology
Prognosis
Minimal residual disease
body regions
Regimen
Leukemia, Myeloid, Acute
MRD
Inflammatory diseases Radboud Institute for Health Sciences [Radboudumc 5]
Molecular Medicine
business
After treatment
medicine.drug
Rare cancers Radboud Institute for Health Sciences [Radboudumc 9]
Subjects
Details
- ISSN :
- 26666367 and 26666375
- Volume :
- 27
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Transplantation and cellular therapy
- Accession number :
- edsair.doi.dedup.....2723db2420eced73ef924d8579840b0f