Article (Scientific journals)
Effect of postremission therapy before reduced-intensity conditioning allogeneic transplantation for acute myeloid leukemia in first complete remission
Warlick, Erica; Paulson, Kristjan; Brazauskas, Ruta et al.
2014In Biology of Blood and Marrow Transplantation, 20 (2), p. 202-208
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Keywords :
AML; RIC; cytarabine consolidation
Abstract :
[en] The impact of pre transplant (HCT) cytarabine consolidation therapy on post HCT outcomes has yet to be evaluated after reduced intensity or non-myeloablative conditioning. We analyzed 604 adults with acute myeloid leukemia (AML) in first complete remission (CR1) reported to the CIBMTR who received a RIC or NMA HCT from an HLA-identical sibling, HLA-matched unrelated donor (URD), or umbilical cord blood (UCB) donor in 2000-2010. We compared transplant outcomes based on exposure to cytarabine post remission consolidation. Three year survival rates were 36% (29-43%, 95% CI) in the no consolidation arm and 42% (37-47%, 95% CI) in the cytarabine consolidation arm (p=0.16). Disease free survival was 34% (27-41%, 95% CI) and 41% (35-46%, 95% CI) (p=0.15), respectively. Three year cumulative incidences of relapse were 37% (30-44%, 95% CI) and 38% (33-43%, 95% CI), respectively (p=0.80). Multivariate regression confirmed no effect of consolidation on relapse, DFS and survival. Prior to RIC/NMA HCT, these data suggest pre-HCT consolidation cytarabine does not significantly alter outcomes and support prompt transition to transplant as soon as morphologic CR1 is attained. If HCT is delayed while identifying a donor, our data suggest that consolidation does not increase transplant TRM and is reasonable if required.
Disciplines :
Hematology
Author, co-author :
Warlick, Erica
Paulson, Kristjan
Brazauskas, Ruta
Zhong, Xiaobo
Miller, Alan
Camitta, Bruce
George, Biju
Savani, Bipin
Ustun, Celalettin
Marks, David
Waller, Edmund
Baron, Frédéric  ;  Université de Liège - ULiège > GIGA-R : Hématologie
Freytes, César
Socie, Gérard
Akpek, Gorgun
Schouten, Harry
Lazarus, Hillard
Horwitz, Edwin
Koreth, John
Cahn, Jean-Yves
Bornhauser, Martin
Seftel, Matthew
Cairo, Mitchell
Laughlin, Mary
Sabloff, Mitchell
Ringdén, Olle
Peter Gale, Robert
Kamble, Rammurti
Vij, Ravi
Gergis, Usama
Mathews, Vikram
Saber, Wael
Chen, Yi-Bin
Liesveld, Jane
Cutler, Corey
Ghobadi, Armin
Uy, Geoffrey
Eapen, Mary
Weisdorf, Daniel
Litzow, Mark
More authors (30 more) Less
Language :
English
Title :
Effect of postremission therapy before reduced-intensity conditioning allogeneic transplantation for acute myeloid leukemia in first complete remission
Publication date :
February 2014
Journal title :
Biology of Blood and Marrow Transplantation
ISSN :
1083-8791
eISSN :
1523-6536
Publisher :
Carden Jennings Publishing, Charlottesville, United States - Virginia
Volume :
20
Issue :
2
Pages :
202-208
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 19 November 2013

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