Allogeneic Hematopoietic Cell Transplantation Outcomes in Acute Myeloid Leukemia: Similar Outcomes Regardless of Donor Type

Erica D. Warlick, Regis Peffault de Latour, Ryan Shanley, Marie Robin, Nelli Bejanyan, Alienor Xhaard, Claudio Brunstein, Flore Sicre de Fontbrune, Celalettin Ustun, Daniel J. Weisdorf, Gerard Socie

Research output: Contribution to journalArticle

30 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)357-363
Number of pages7
JournalBiology of Blood and Marrow Transplantation
Volume21
Issue number2
DOIs
StatePublished - Feb 1 2015

Keywords

  • Acute myeloid leukemia
  • Allogeneic hematopoietic stem cell transplantation

Fingerprint Dive into the research topics of 'Allogeneic Hematopoietic Cell Transplantation Outcomes in Acute Myeloid Leukemia: Similar Outcomes Regardless of Donor Type'. Together they form a unique fingerprint.

  • Cite this