Allogeneic hematopoietic cell transplant for AML: No impact of pre-transplant extramedullary disease on outcome Journal Article
| Authors: | Goyal, S. D.; Zhang, M. J.; Wang, H. L.; Akpek, G.; Copelan, E. A.; Freytes, C.; Gale, R. P.; Hamadani, M.; Inamoto, Y.; Kamble, R. T.; Lazarus, H. M.; Marks, D. I.; Nishihori, T.; Olsson, R. F.; Reshef, R.; Ritchie, D. S.; Saber, W.; Savani, B. N.; Seber, A.; Shea, T. C.; Tallman, M. S.; Wirk, B.; Bunjes, D. W.; Devine, S. M.; de Lima, M.; Weisdorf, D. J.; Uy, G. L. |
| Article Title: | Allogeneic hematopoietic cell transplant for AML: No impact of pre-transplant extramedullary disease on outcome |
| Abstract: | The impact of extramedullary disease (EMD) in AML on the outcomes of allogeneic hematopoietic cell transplantation (alloHCT) is unknown. Using data from the Center for International Blood and Marrow Transplant Research, we compared the outcomes of patients who had EMD of AML at any time before transplant, with a cohort of AML patients without EMD. We reviewed data from 9797 AML patients including 814 with EMD from 310 reporting centers and 44 different countries, who underwent alloHCT between and 1995 and 2010. The primary outcome was overall survival (OS) after alloHCT. Secondary outcomes included leukemia-free survival (LFS), relapse rate and treatment-related mortality (TRM). In a multivariate analysis, the presence of EMD did not affect either OS (hazard ratio 1.00, 95% confidence interval (CI) 0.91-1.09), LFS (0.98, 0.89-1.09), TRM (relative risk 0.92, 95% CI 0.80-1.16, P=0.23) or relapse (relative risk=1.03, 95% CI, 0.92-1.16; P=0.62). Furthermore, the outcome of patients with EMD was not influenced by the location, timing of EMD, or intensity of conditioning regimen. The presence of EMD in AML does not affect transplant outcomes and should not be viewed as an independent adverse prognostic feature. © 2015 Macmillan Publishers Limited. |
| Keywords: | adult; controlled study; aged; major clinical study; overall survival; disease free survival; outcome assessment; recurrence risk; cancer mortality; acute graft versus host disease; chronic graft versus host disease; acute myeloblastic leukemia; allogeneic hematopoietic stem cell transplantation; immunosuppressive treatment; leukemia relapse; granulocytic sarcoma; human; male; female; priority journal; article |
| Journal Title: | Bone Marrow Transplantation |
| Volume: | 50 |
| Issue: | 8 |
| ISSN: | 0268-3369 |
| Publisher: | Nature Publishing Group |
| Date Published: | 2015-08-01 |
| Start Page: | 1057 |
| End Page: | 1062 |
| Language: | English |
| DOI: | 10.1038/bmt.2015.82 |
| PROVIDER: | scopus |
| PMCID: | PMC4527880 |
| PUBMED: | 25915806 |
| DOI/URL: | |
| Notes: | Export Date: 2 September 2015 -- Source: Scopus |
