TY - JOUR
T1 - A long-term follow-up report on allogeneic stem cell transplantation for patients with primary refractory acute myelogenous leukemia
T2 - Impact of cytogenetic characteristics on transplantation outcome
AU - Fung, H. C.
AU - Stein, A.
AU - Slovak, M. L.
AU - O'Donnell, M. R.
AU - Snyder, D. S.
AU - Cohen, S.
AU - Smith, D.
AU - Krishnan, A.
AU - Spielberger, R.
AU - Bhatia, R.
AU - Bhatia, S.
AU - Falk, P.
AU - Molina, A.
AU - Nademanee, A.
AU - Parker, P.
AU - Rodriguez, R.
AU - Rosenthal, J.
AU - Sweetman, R.
AU - Kogut, N.
AU - Sahebi, F.
AU - Popplewell, L.
AU - Vora, N.
AU - Somlo, G.
AU - Margolin, K.
AU - Chow, W.
AU - Smith, E.
AU - Forman, S. J.
PY - 2003/12
Y1 - 2003/12
N2 - The prognosis of patients with primary refractory acute myelogenous leukemia (AML) is poor. Our initial report suggested that some patients could achieve durable remission after allogeneic stem cell transplantation (SCT). Herein, we update our initial experience and report further analysis of this group of patients to determine whether there are pre-SCT prognostic factors predictive of posttransplantation relapse and survival. We reviewed the records of 68 patients who consecutively underwent transplantation at the City of Hope Cancer Center with allogeneic SCT for primary refractory AML between July 1978 and August 2000. Potential factors associated with overall survival and disease-free survival were examined. With a median follow-up of 3 years, the 3-year cumulative probabilities of disease-free survival (DFS), overall survival (OS), and relapse rate for all 68 patients were 31% (95% confidence interval [CI], 20%-42%), 30% (95% CI, 18%-41%), and 51% (95% CI, 38%-65%), respectively. In multivariate analysis, the only variables associated with shortened OS and DFS included the use of an unrelated donor as the stem cell source (relative risk, 2.23 [OS] and 2.05 [DFS]; P = .0005 and .0014, respectively) and unfavorable cytogenetics before SCT (relative risk: 1.68 [OS] and 1.58 [DFS]; P = .0107 and .0038, respectively). Allogeneic SCT can cure approximately one third of patients with primary refractory AML. Cytogenetic characteristics before SCT correlate with transplantation outcome and posttransplantation relapse.
AB - The prognosis of patients with primary refractory acute myelogenous leukemia (AML) is poor. Our initial report suggested that some patients could achieve durable remission after allogeneic stem cell transplantation (SCT). Herein, we update our initial experience and report further analysis of this group of patients to determine whether there are pre-SCT prognostic factors predictive of posttransplantation relapse and survival. We reviewed the records of 68 patients who consecutively underwent transplantation at the City of Hope Cancer Center with allogeneic SCT for primary refractory AML between July 1978 and August 2000. Potential factors associated with overall survival and disease-free survival were examined. With a median follow-up of 3 years, the 3-year cumulative probabilities of disease-free survival (DFS), overall survival (OS), and relapse rate for all 68 patients were 31% (95% confidence interval [CI], 20%-42%), 30% (95% CI, 18%-41%), and 51% (95% CI, 38%-65%), respectively. In multivariate analysis, the only variables associated with shortened OS and DFS included the use of an unrelated donor as the stem cell source (relative risk, 2.23 [OS] and 2.05 [DFS]; P = .0005 and .0014, respectively) and unfavorable cytogenetics before SCT (relative risk: 1.68 [OS] and 1.58 [DFS]; P = .0107 and .0038, respectively). Allogeneic SCT can cure approximately one third of patients with primary refractory AML. Cytogenetic characteristics before SCT correlate with transplantation outcome and posttransplantation relapse.
KW - Acute myelogenous leukemia
KW - Allogeneic stem cell transplantation
KW - Cytogenetic characteristics
KW - Treatment failure
UR - http://www.scopus.com/inward/record.url?scp=0742306141&partnerID=8YFLogxK
U2 - 10.1016/j.bbmt.2003.08.004
DO - 10.1016/j.bbmt.2003.08.004
M3 - Article
C2 - 14677116
AN - SCOPUS:0742306141
SN - 1083-8791
VL - 9
SP - 766
EP - 771
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 12
ER -
