TY - JOUR
T1 - Allogeneic Hematopoietic Cell Transplantation Outcomes in Acute Myeloid Leukemia
T2 - Similar Outcomes Regardless of Donor Type
AU - Warlick, Erica D.
AU - Peffault de Latour, Regis
AU - Shanley, Ryan
AU - Robin, Marie
AU - Bejanyan, Nelli
AU - Xhaard, Alienor
AU - Brunstein, Claudio
AU - Sicre de Fontbrune, Flore
AU - Ustun, Celalettin
AU - Weisdorf, Daniel J.
AU - Socie, Gerard
N1 - Publisher Copyright:
© 2015 American Society for Blood and Marrow Transplantation.
PY - 2015/2/1
Y1 - 2015/2/1
N2 - The use of alternative donor transplants is increasing as the transplantation-eligible population ages and sibling donors are less available. We evaluated the impact of donor source on transplantation outcomes for adults with acute myeloid leukemia undergoing myeloablative (MA) or reduced-intensity conditioning (RIC) transplantation. Between January 2000 and December 2010, 414 consecutive adult patients with acute myeloid leukemia in remission received MA or RIC allogeneic transplantation from either a matched related donor (n=187), unrelated donor (n=76), or umbilical cord blood donor (n=151) at the University of Minnesota or HÔpital St. Louis in Paris. We noted similar 6-year overall survival across donor types: matched related donor, 47% (95% confidence interval [CI], 39% to 54%); umbilical cord blood, 36% (95% CI, 28% to 44%); matched unrelated donor, 54% (95% CI, 40% to 66%); and mismatched unrelated donor, 51% (95% CI, 28% to 70%) (. P <.11). Survival differed based on conditioning intensity and age, with 6-year survival of 57% (95% CI, 47% to 65%), 39% (95% CI, 28% to 49%), 23% (95% CI, 6% to 47%), 47% (95% CI, 36% to 57%), and 28% (95% CI, 17% to 41%) for MA age 18 to 39, MA age 40+, or RIC ages 18 to 39, 40 to 56, and 57 to 74, respectively (. P<.01). Relapse was increased with RIC and lowest in younger patients receiving MA conditioning (hazard ratio, 1.0 versus 2.5 or above for all RIC age cohorts), P <.01. Transplantation-related mortality was similar across donor types. In summary, our data support the use of alternative donors as a graft source with MA or RIC for patients with acute myeloid leukemia when a sibling donor is unavailable.
AB - The use of alternative donor transplants is increasing as the transplantation-eligible population ages and sibling donors are less available. We evaluated the impact of donor source on transplantation outcomes for adults with acute myeloid leukemia undergoing myeloablative (MA) or reduced-intensity conditioning (RIC) transplantation. Between January 2000 and December 2010, 414 consecutive adult patients with acute myeloid leukemia in remission received MA or RIC allogeneic transplantation from either a matched related donor (n=187), unrelated donor (n=76), or umbilical cord blood donor (n=151) at the University of Minnesota or HÔpital St. Louis in Paris. We noted similar 6-year overall survival across donor types: matched related donor, 47% (95% confidence interval [CI], 39% to 54%); umbilical cord blood, 36% (95% CI, 28% to 44%); matched unrelated donor, 54% (95% CI, 40% to 66%); and mismatched unrelated donor, 51% (95% CI, 28% to 70%) (. P <.11). Survival differed based on conditioning intensity and age, with 6-year survival of 57% (95% CI, 47% to 65%), 39% (95% CI, 28% to 49%), 23% (95% CI, 6% to 47%), 47% (95% CI, 36% to 57%), and 28% (95% CI, 17% to 41%) for MA age 18 to 39, MA age 40+, or RIC ages 18 to 39, 40 to 56, and 57 to 74, respectively (. P<.01). Relapse was increased with RIC and lowest in younger patients receiving MA conditioning (hazard ratio, 1.0 versus 2.5 or above for all RIC age cohorts), P <.01. Transplantation-related mortality was similar across donor types. In summary, our data support the use of alternative donors as a graft source with MA or RIC for patients with acute myeloid leukemia when a sibling donor is unavailable.
KW - Acute myeloid leukemia
KW - Allogeneic hematopoietic stem cell transplantation
UR - http://www.scopus.com/inward/record.url?scp=84920895524&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84920895524&partnerID=8YFLogxK
U2 - 10.1016/j.bbmt.2014.10.030
DO - 10.1016/j.bbmt.2014.10.030
M3 - Article
C2 - 25452032
AN - SCOPUS:84920895524
SN - 1083-8791
VL - 21
SP - 357
EP - 363
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 2
ER -