Allogeneic hematopoietic cell transplantation in intermediate risk acute myeloid leukemia negative for FLT3-ITD, NPM1- or biallelic CEBPA mutations
Background: The value of allogeneic hematopoietic cell transplantation (alloHCT) as postremission treatment is not well defined for patients with intermediate-risk acute myeloid leukemia (AML) without FLT3-ITD, biallelic CEBPA-, or NPM1 mutations (here referred to as NPM1mut-neg/CEBPAdm-neg/FLT3-ITD...
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| Main Authors: | , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
01 September 2017
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| In: |
Annals of oncology
Year: 2017, Volume: 28, Issue: 11, Pages: 2793-2798 |
| ISSN: | 1569-8041 |
| DOI: | 10.1093/annonc/mdx500 |
| Online Access: | Verlag, kostenfrei registrierungspflichtig, Volltext: http://dx.doi.org/10.1093/annonc/mdx500 Verlag, kostenfrei registrierungspflichtig, Volltext: https://academic.oup.com/annonc/article/28/11/2793/4101658 
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| Author Notes: | K. Heidrich, C. Thiede, K. Schäfer-Eckart, N. Schmitz, W.E. Aulitzky, A. Krämer, W. Rösler, M. Hänel, H. Einsele, C.D. Baldus, R.U. Trappe, F. Stölzel, J.M. Middeke, C. Röllig, F. Taube, M. Kramer, H. Serve, W.E. Berdel, G. Ehninger, M. Bornhäuser, J. Schetelig |
| Summary: | Background: The value of allogeneic hematopoietic cell transplantation (alloHCT) as postremission treatment is not well defined for patients with intermediate-risk acute myeloid leukemia (AML) without FLT3-ITD, biallelic CEBPA-, or NPM1 mutations (here referred to as NPM1mut-neg/CEBPAdm-neg/FLT3-ITDneg AML) in first complete remission (CR1). Patients and methods: We addressed this question using data from two prospective randomized controlled trials on intensive induction- and risk-stratified postremission therapy. The NPM1mut-neg/CEBPAdm-neg/FLT3-ITDneg AML subgroup comprised 497 patients, aged 18-60 years. Results: In donor versus no-donor analyses, patients with a matched related donor had a longer relapse-free survival (HR 0.5; 95% CI 0.3-0.9, P = 0.02) and a trend toward better overall survival (HR 0.6, 95% CI 0.3-1.1, P = 0.08) compared with patients who received postremission chemotherapy. Notably, only 58% of patients in the donor group were transplanted in CR1. We therefore complemented the donor versus no-donor analysis with multivariable Cox regression analyses, where alloHCT was tested as a time-dependent covariate: overall survival (HR 0.58, 95% CI 0.37-0.9, P = 0.02) and relapse-free survival (HR 0.51, 95% CI 0.34-0.76; P = 0.001) for patients who received alloHCT compared with chemotherapy in CR1 were significantly longer. Conclusion: Outside clinical trials, alloHCT should be the preferred postremission treatment of patients with intermediate risk NPM1mut-neg/CEBPAdm-neg/FLT3-ITDneg AML in CR1.Cinicaltrials.gov identifierNCT00180115, NCT00180102 |
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| Item Description: | Gesehen am 12.04.2018 |
| Physical Description: | Online Resource |
| ISSN: | 1569-8041 |
| DOI: | 10.1093/annonc/mdx500 |