Superior transplantation outcomes of 8/8-matched unrelated donors as well as matched siblings to autologous transplantation for acute myeloid leukemia with intermediate cytogenetics in first remission
Version of Record online: 15 MAR 2013
© 2013 John Wiley & Sons A/S
European Journal of Haematology
Volume 90, Issue 5, pages 365–374, May 2013
How to Cite
Cho, B.-S., Kim, J.-H., Yoon, J.-H., Shin, S.-H., Yahng, S.-A., Lee, S.-E., Eom, K.-S., Kim, Y.-J., Lee, S., Min, C.-K., Cho, S.-G., Kim, D.-W., Lee, J.-W., Min, W.-S., Park, C.-W. and Kim, H.-J. (2013), Superior transplantation outcomes of 8/8-matched unrelated donors as well as matched siblings to autologous transplantation for acute myeloid leukemia with intermediate cytogenetics in first remission. European Journal of Haematology, 90: 365–374. doi: 10.1111/ejh.12089
- Issue online: 18 APR 2013
- Version of Record online: 15 MAR 2013
- Accepted manuscript online: 16 FEB 2013 12:08PM EST
- Manuscript Accepted: 8 FEB 2013
- National R&D Program for Cancer Control
- Ministry for Health and Welfare, Republic of Korea. Grant Number: 1020370
- unrelated donors;
- HLA-matched siblings;
- autologous transplantation;
- acute myeloid leukemia
For patients with acute myeloid leukemia in first complete remission (AML CR1) lacking HLA-matched sibling donors (MSD), 8/8-matched unrelated donors (URD) are mostly used in cases with poor-risk features. For AML CR1 with intermediate cytogenetics, however, the benefit of 8/8-matched URD should be compared with non-allogeneic therapies as well as MSD.
To address this issue, we assessed the transplantation outcomes of 8/8-matched URD (n = 54) compared with MSD (n = 145) or autologous transplantation (n = 89) for AML CR1 with intermediate cytogenetics.
In multivariate analyses, 8/8-matched URD had comparable 6-yr overall survival (OS, P = 0.997), disease-free survival (DFS, P = 0.951), and relapse (P = 0.672) to MSD, whereas 8/8-matched URD had a higher OS (P = 0.070) and DFS (P = 0.035) with lower relapse (P = 0.009) than autologous transplantation. No difference in non-relapse mortality was observed according to donor type. Notably, these equivalent or superior outcomes of 8/8-matched URD compared with MSD or autologous transplantation, respectively, were particularly evident in patients without poor-risk features (n = 200), such as older age, hyperleukocytosis at diagnosis, and myelodysplasia-related changes, who are not usual candidates for URD transplantation.
These results indicate that 8/8-matched URD are feasible next option in AML CR1 with intermediate cytogenetics, when lacking MSD, even in patients without poor-risk features.