Allogeneic hematopoietic cell transplant for AML: No impact of pre-transplant extramedullary disease on outcome

S. D. Goyal; M. J. Zhang; H. L. Wang; G. Akpek; E. A. Copelan; C. Freytes; R. P. Gale; M. Hamadani; Y. Inamoto; R. T. Kamble; H. M. Lazarus; D. I. Marks; T. Nishihori; R. F. Olsson; R. Reshef; D. S. Ritchie; W. Saber; B. N. Savani; A. Seber; T. C. Shea; M. S. Tallman; B. Wirk; D. W. Bunjes; S. M. Devine; M. De Lima; D. J. Weisdorf; G. L. Uy

doi:10.1038/bmt.2015.82

Allogeneic hematopoietic cell transplant for AML: No impact of pre-transplant extramedullary disease on outcome

S. D. Goyal, M. J. Zhang, H. L. Wang, G. Akpek, E. A. Copelan, C. Freytes, R. P. Gale, M. Hamadani, Y. Inamoto, R. T. Kamble, H. M. Lazarus, D. I. Marks, T. Nishihori, R. F. Olsson, R. Reshef, D. S. Ritchie, W. Saber, B. N. Savani, A. Seber, T. C. SheaM. S. Tallman, B. Wirk, D. W. Bunjes, S. M. Devine, M. De Lima, D. J. Weisdorf, G. L. Uy

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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.

Original language	English (US)
Pages (from-to)	1057-1062
Number of pages	6
Journal	Bone marrow transplantation
Volume	50
Issue number	8
DOIs	https://doi.org/10.1038/bmt.2015.82
State	Published - Aug 8 2015

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© 2015 Macmillan Publishers Limited.

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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., ... Uy, G. L. (2015). Allogeneic hematopoietic cell transplant for AML: No impact of pre-transplant extramedullary disease on outcome. Bone marrow transplantation, 50(8), 1057-1062. https://doi.org/10.1038/bmt.2015.82

Goyal, SD, Zhang, MJ, Wang, HL, Akpek, G, Copelan, EA, Freytes, C, Gale, RP, Hamadani, M, Inamoto, Y, Kamble, RT, Lazarus, HM, Marks, DI, Nishihori, T, Olsson, RF, Reshef, R, Ritchie, DS, Saber, W, Savani, BN, Seber, A, Shea, TC, Tallman, MS, Wirk, B, Bunjes, DW, Devine, SM, De Lima, M, Weisdorf, DJ & Uy, GL 2015, 'Allogeneic hematopoietic cell transplant for AML: No impact of pre-transplant extramedullary disease on outcome', Bone marrow transplantation, vol. 50, no. 8, pp. 1057-1062. https://doi.org/10.1038/bmt.2015.82

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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.",

author = "Goyal, {S. D.} and Zhang, {M. J.} and Wang, {H. L.} and G. Akpek and Copelan, {E. A.} and C. Freytes and Gale, {R. P.} and M. Hamadani and Y. Inamoto and Kamble, {R. T.} and Lazarus, {H. M.} and Marks, {D. I.} and T. Nishihori and Olsson, {R. F.} and R. Reshef and Ritchie, {D. S.} and W. Saber and Savani, {B. N.} and A. Seber and Shea, {T. C.} and Tallman, {M. S.} and B. Wirk and Bunjes, {D. W.} and Devine, {S. M.} and {De Lima}, M. and Weisdorf, {D. J.} and Uy, {G. L.}",

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T2 - No impact of pre-transplant extramedullary disease on outcome

AU - Goyal, S. D.

AU - Zhang, M. J.

AU - Wang, H. L.

AU - Akpek, G.

AU - Copelan, E. A.

AU - Freytes, C.

AU - Gale, R. P.

AU - Hamadani, M.

AU - Inamoto, Y.

AU - Kamble, R. T.

AU - Lazarus, H. M.

AU - Marks, D. I.

AU - Nishihori, T.

AU - Olsson, R. F.

AU - Reshef, R.

AU - Ritchie, D. S.

AU - Saber, W.

AU - Savani, B. N.

AU - Seber, A.

AU - Shea, T. C.

AU - Tallman, M. S.

AU - Wirk, B.

AU - Bunjes, D. W.

AU - Devine, S. M.

AU - De Lima, M.

AU - Weisdorf, D. J.

AU - Uy, G. L.

PY - 2015/8/8

Y1 - 2015/8/8

N2 - 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.

AB - 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.

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Allogeneic hematopoietic cell transplant for AML: No impact of pre-transplant extramedullary disease on outcome

Abstract

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