Neoplasma Vol.60, No.5, p.576-583, 2013
|Title: The outcome of allogeneic HSCT in older AML patients is determined by disease biology and not by the donor type: An analysis of 96 allografted AML patients ≥50 years from the Czech acute leukaemia clinical register (alert)|
|Author: P. Jindra, J. Muzik, K. Indrak, P. Zak, F. A. Sabty, T. Kozak, P. Cetkovsky, V. Koza,M. Karas, L. Raida, T. Szotkowski|
Older patients with AML have poor prognosis after chemotherapy and allo-SCT was historically limited to the young patients.
In the multicentre retrospective study we analyzed 96 consecutive AML patients ≥ 50 years allografted with related (n=59) or unrelated (n=37) donor.
The 2- year OS and DFS rates were 45 % and 42 % for the whole group.
The corresponding figures for related patients were 48% and 42% whereas for unrelated 42% and 42%, respectively (OS p=0,721, DFS p = 0,896).
The cumulative incidences of relapse (28% of all patients) and NRM mortality (26%) were low with no significant differences among related and unrelated cohorts.
Multivariate analysis revealed the only major independent variables associated with an inferior OS were unfavourable cytogenetics (RR 3.36; CI 1.66-6.83; p=0.001) and advanced disease status (RR 2.30; CI 1.21-4.37; p=0.011).
Unfavourable cytogenetics (RR 3.00; CI 1.50-5.99; p=0.002) and advanced disease at SCT (RR 2.27; CI 1.22-4.22; p=0.009) were also the only independent variables associated with inferior DFS.
In conclusion, our analysis indicates that outcomes of allografted AML patients aged ≥ 50 years are determined by cytogenetic risk category and disease status at transplantation and not by the type of donor.
|Keywords: AML, allogeneic HSCT, age, donor|
|Published online: 24-Jun-2013|
|Year: 2013, Volume: 60, Issue: 5||Page From: 576, Page To: 583|