Universität zu Köln

Malard, Florent, Labopin, Myriam, Stuhler, Gernot, Bittenbring, Joerg, Ganser, Arnold, Tischer, Johanna, Michallet, Mauricette, Kroeger, Nicolaus, Schmid, Christoph, Hallek, Michael, Savani, Bipin N., Mohty, Mohamad and Nagler, Arnon (2017). Sequential Intensified Conditioning Regimen Allogeneic Hematopoietic Stem Cell Transplantation in Adult Patients with Intermediate- or High-Risk Acute Myeloid Leukemia in Complete Remission: A Study from the Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation. Biol. Blood Marrow Transplant., 23 (2). S. 278 - 285. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1523-6536

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Abstract

Post-transplant relapse is the leading cause of treatment failure in acute myeloid leukemia (AML) patients after reduced intensity conditioning allogeneic hematopoietic stem cell transplantation (allo-HSCT). To improve their outcome, we evaluated the outcome of a sequential intermediate-intensity conditioning regimen combining fludarabine, cytosine arabinoside, amsacrine, cyclophosphamide, and either total body irradiation or busulfan (FLAMSA) in patients with intermediate or high-risk AML in first or second complete remission (CR). A total of 265 patients (median age, 55 years; range, 19 to 76) with AML who underwent allo-HSCT using a FLAMSA regimen were included. At the time of transplant, 216 (81.5%) were in CR1 and 49 (18.5%) in CR2. Cytogenetic was intermediate in 114 (43%) and poor in 42 (15.8%) patients, whereas 109 patients (41.1%) had a secondary AML. With a median follow-up of 46 months (range, 1 to 145), the Kaplan-Meier estimate of overall and leukemia-free survival at 2 years were 56.1% (95% CI, 49.7% to 62.6%) and 52.8% (95% CI, 46.4% to 59.2%), respectively. At 2 years, the cumulative incidences of relapse and nonrelapse mortality were 22.8% (95% CI, 17.6% to 28.4%) and 24.0% (95% CI, 18.8% to 29.5%), respectively. In multivariate analysis, patient age and cytogenetics were the only parameters with a significant impact on overall survival. These data suggest that the FLAMSA sequential intermediate conditioning regimen provides an efficient disease control in intermediate- and high-risk AML patients, including those in CR2 and with secondary AML (C) 2017 American Society for Blood and Marrow Transplantation.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Malard, Florent UNSPECIFIED UNSPECIFIED UNSPECIFIED Labopin, Myriam UNSPECIFIED UNSPECIFIED UNSPECIFIED Stuhler, Gernot UNSPECIFIED UNSPECIFIED UNSPECIFIED Bittenbring, Joerg UNSPECIFIED UNSPECIFIED UNSPECIFIED Ganser, Arnold UNSPECIFIED UNSPECIFIED UNSPECIFIED Tischer, Johanna UNSPECIFIED UNSPECIFIED UNSPECIFIED Michallet, Mauricette UNSPECIFIED UNSPECIFIED UNSPECIFIED Kroeger, Nicolaus UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmid, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Hallek, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Savani, Bipin N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mohty, Mohamad UNSPECIFIED UNSPECIFIED UNSPECIFIED Nagler, Arnon UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-241366
DOI:	10.1016/j.bbmt.2016.11.002
Journal or Publication Title:	Biol. Blood Marrow Transplant.
Volume:	23
Number:	2
Page Range:	S. 278 - 285
Date:	2017
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1523-6536
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language 1ST COMPLETE REMISSION; REDUCED-INTENSITY; MYELODYSPLASTIC SYNDROME; BUSULFAN; CHEMOTHERAPY; FLUDARABINE; SURVIVAL; TRIAL; OLDER; EBMT Multiple languages Hematology; Immunology; Transplantation Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/24136