Pretransplantation consolidation chemotherapy decreases leukemia relapse after autologous blood and bone marrow transplants for acute myelogenous leukemia in first remission

Martin S. Tallman; Waleska S. Pérez; Hillard M. Lazarus; Robert Peter Gale; Richard T. Maziarz; Jacob M. Rowe; David I. Marks; Jean Yves Cahn; Asad Bashey; Michael R. Bishop; Neal Christiansen; Stanley R. Frankel; Juan J. García; Osman Ilhan; Mary J. Laughlin; Jane Liesveld; Charles Linker; Mark R. Litzow; Selina Luger; Philip L. McCarthy; Gustavo A. Milone; Santiago Pavlovsky; Gordon L. Phillips; James A. Russell; Ruben A. Saez; Gary Schiller; Jorge Sierra; Roy S. Weiner; Axel R. Zander; Mei Jie Zhang; Armand Keating; Daniel J. Weisdorf; Mary M. Horowitz

doi:10.1016/j.bbmt.2005.10.013

Pretransplantation consolidation chemotherapy decreases leukemia relapse after autologous blood and bone marrow transplants for acute myelogenous leukemia in first remission

Martin S. Tallman, Waleska S. Pérez, Hillard M. Lazarus, Robert Peter Gale, Richard T. Maziarz, Jacob M. Rowe, David I. Marks, Jean Yves Cahn, Asad Bashey, Michael R. Bishop, Neal Christiansen, Stanley R. Frankel, Juan J. García, Osman Ilhan, Mary J. Laughlin, Jane Liesveld, Charles Linker, Mark R. Litzow, Selina Luger, Philip L. McCarthyGustavo A. Milone, Santiago Pavlovsky, Gordon L. Phillips, James A. Russell, Ruben A. Saez, Gary Schiller, Jorge Sierra, Roy S. Weiner, Axel R. Zander, Mei Jie Zhang, Armand Keating, Daniel J. Weisdorf, Mary M. Horowitz

Research output: Contribution to journal › Article › peer-review

24 Scopus citations

Abstract

Controversy exists over whether pretransplantation consolidation chemotherapy affects the outcome of subsequent autotransplantation for acute myelogenous leukemia (AML). The current study was undertaken to determine the association between previous consolidation and outcome of autotransplantation for AML in first remission. Posttransplantation outcomes of 146 patients receiving no consolidation were compared with those of 244 patients receiving standard-dose (<1 gm/m²) and 249 patients receiving high-dose (1-3 gm/m²) cytarabine, using proportional hazards regression to adjust for differences in prognostic variables. One-year transplantation-related mortality was similar among the cohorts. Five-year relapse rates were 49% (95% confidence interval CI = 39%-58%) with no consolidation, 35% (95% CI = 29%-42%) with standard-dose cytarabine, and 40% (95% CI = 33%-48%) with high-dose cytarabine (P = .07). Five-year leukemia-free survival rates were 39% (95% CI = 30%-47%) with no consolidation, 53% (95% CI = 46%-60%) with standard-dose cytarabine, and 48% (95% CI = 40%-56%) with high-dose cytarabine (P = .03). Similarly, 5-year overall survival was better in those patients receiving consolidation: 42% (95% CI = 34%-51%) with no consolidation, 59% (95% CI = 52%-65%) with standard-dose cytarabine, and 54% (95% CI = 46%-61%) with high-dose cytarabine (P = .01). Although most patients received 1 or 2 cycles of consolidation, the number of courses had no detectable effect on transplantation outcome. In multivariate analysis, risks of relapse and treatment failure were lower in the patients receiving consolidation, especially among those patients receiving blood cell grafts. Outcomes with standard-dose and high-dose cytarabine were similar. Based on our findings, we recommend that patients with AML in first remission receive consolidation before undergoing autotransplantation.

Original language	English (US)
Pages (from-to)	204-216
Number of pages	13
Journal	Biology of Blood and Marrow Transplantation
Volume	12
Issue number	2
DOIs	https://doi.org/10.1016/j.bbmt.2005.10.013
State	Published - Feb 2006

Bibliographical note

Funding Information:
This work was supported by Public Health Service Grant U24-CA76518 from the National Cancer Institute, the National Institute of Allergy and Infectious Diseases, and the National Heart, Lung and Blood Institute; the Office of Naval Research; the Health Resources Services Administration (DHHS); AABB, Aetna; AIG Medical Excess; American Red Cross; Amgen; Inc.; an anonymous donation to the Medical College of Wisconsin; AnorMED, Inc.; Berlex Laboratories, Inc.; Biogen IDEC, Inc.; Blue Cross and Blue Shield Association; BRT Laboratories, Inc.; Celgene Corp.; Cell Therapeutics, Inc.; CelMed Biosciences; Cubist Pharmaceuticals; Dynal Biotech, LLC; Edwards Lifesciences RMI; Endo Pharmaceuticals, Inc.; Enzon Pharmaceuticals, Inc.; ESP Pharma; Fujisawa Healthcare, Inc.; Gambro BCT, Inc.; Genzyme Corporation; GlaxoSmithKline, Inc.; Histogenetics, Inc.; Human Genome Sciences; ILEX Oncology, Inc.; Kirin Brewery Company; Ligand Pharmaceuticals, Inc.; Merck & Company; Millennium Pharmaceuticals; Miller Pharmacal Group; Milliman USA, Inc.; Miltenyi Biotec; National Center for Biotechnology Information; National Leukemia Research Association; National Marrow Donor Program; NeoRx Corporation; Novartis Pharmaceuticals, Inc.; Novo Nordisk Pharmaceuticals; Ortho Biotech, Inc.; Osiris Therapeutics, Inc.; Pall Medical; Pfizer, Inc.; Pharmion Corp.; QOL Medical; Roche Laboratories; StemCyte, Inc.; Stemco Biomedical; StemSoft Software, Inc.; SuperGen, Inc.; Sysmex; The Marrow Foundation; THERAKOS, a Johnson & Johnson company; University of Colorado Cord Blood Bank; Valeant Pharmaceuticals; ViaCell, Inc.; ViraCor Laboratories; W.B. Saunders, Mosby, Churchill Livingstone; and Wellpoint Health Network. The contents of this article are the responsibility of the authors and do not represent the official views of the National Cancer Institute.

Keywords

Acute myelogenous leukemia
Autologous
Autotransplantation
Consolidation
Transplantation

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Publisher link

10.1016/j.bbmt.2005.10.013

Find It

Find It at U of M Libraries

Cite this

Tallman, M. S., Pérez, W. S., Lazarus, H. M., Gale, R. P., Maziarz, R. T., Rowe, J. M., Marks, D. I., Cahn, J. Y., Bashey, A., Bishop, M. R., Christiansen, N., Frankel, S. R., García, J. J., Ilhan, O., Laughlin, M. J., Liesveld, J., Linker, C., Litzow, M. R., Luger, S., ... Horowitz, M. M. (2006). Pretransplantation consolidation chemotherapy decreases leukemia relapse after autologous blood and bone marrow transplants for acute myelogenous leukemia in first remission. Biology of Blood and Marrow Transplantation, 12(2), 204-216. https://doi.org/10.1016/j.bbmt.2005.10.013

Pretransplantation consolidation chemotherapy decreases leukemia relapse after autologous blood and bone marrow transplants for acute myelogenous leukemia in first remission. / Tallman, Martin S.; Pérez, Waleska S.; Lazarus, Hillard M. et al.
In: Biology of Blood and Marrow Transplantation, Vol. 12, No. 2, 02.2006, p. 204-216.

Research output: Contribution to journal › Article › peer-review

Tallman, MS, Pérez, WS, Lazarus, HM, Gale, RP, Maziarz, RT, Rowe, JM, Marks, DI, Cahn, JY, Bashey, A, Bishop, MR, Christiansen, N, Frankel, SR, García, JJ, Ilhan, O, Laughlin, MJ, Liesveld, J, Linker, C, Litzow, MR, Luger, S, McCarthy, PL, Milone, GA, Pavlovsky, S, Phillips, GL, Russell, JA, Saez, RA, Schiller, G, Sierra, J, Weiner, RS, Zander, AR, Zhang, MJ, Keating, A, Weisdorf, DJ & Horowitz, MM 2006, 'Pretransplantation consolidation chemotherapy decreases leukemia relapse after autologous blood and bone marrow transplants for acute myelogenous leukemia in first remission', Biology of Blood and Marrow Transplantation, vol. 12, no. 2, pp. 204-216. https://doi.org/10.1016/j.bbmt.2005.10.013

@article{171963942ee24e7c9ff61a81d47b5ad4,

title = "Pretransplantation consolidation chemotherapy decreases leukemia relapse after autologous blood and bone marrow transplants for acute myelogenous leukemia in first remission",

abstract = "Controversy exists over whether pretransplantation consolidation chemotherapy affects the outcome of subsequent autotransplantation for acute myelogenous leukemia (AML). The current study was undertaken to determine the association between previous consolidation and outcome of autotransplantation for AML in first remission. Posttransplantation outcomes of 146 patients receiving no consolidation were compared with those of 244 patients receiving standard-dose (<1 gm/m2) and 249 patients receiving high-dose (1-3 gm/m2) cytarabine, using proportional hazards regression to adjust for differences in prognostic variables. One-year transplantation-related mortality was similar among the cohorts. Five-year relapse rates were 49% (95% confidence interval CI = 39%-58%) with no consolidation, 35% (95% CI = 29%-42%) with standard-dose cytarabine, and 40% (95% CI = 33%-48%) with high-dose cytarabine (P = .07). Five-year leukemia-free survival rates were 39% (95% CI = 30%-47%) with no consolidation, 53% (95% CI = 46%-60%) with standard-dose cytarabine, and 48% (95% CI = 40%-56%) with high-dose cytarabine (P = .03). Similarly, 5-year overall survival was better in those patients receiving consolidation: 42% (95% CI = 34%-51%) with no consolidation, 59% (95% CI = 52%-65%) with standard-dose cytarabine, and 54% (95% CI = 46%-61%) with high-dose cytarabine (P = .01). Although most patients received 1 or 2 cycles of consolidation, the number of courses had no detectable effect on transplantation outcome. In multivariate analysis, risks of relapse and treatment failure were lower in the patients receiving consolidation, especially among those patients receiving blood cell grafts. Outcomes with standard-dose and high-dose cytarabine were similar. Based on our findings, we recommend that patients with AML in first remission receive consolidation before undergoing autotransplantation.",

keywords = "Acute myelogenous leukemia, Autologous, Autotransplantation, Consolidation, Transplantation",

author = "Tallman, {Martin S.} and P{\'e}rez, {Waleska S.} and Lazarus, {Hillard M.} and Gale, {Robert Peter} and Maziarz, {Richard T.} and Rowe, {Jacob M.} and Marks, {David I.} and Cahn, {Jean Yves} and Asad Bashey and Bishop, {Michael R.} and Neal Christiansen and Frankel, {Stanley R.} and Garc{\'i}a, {Juan J.} and Osman Ilhan and Laughlin, {Mary J.} and Jane Liesveld and Charles Linker and Litzow, {Mark R.} and Selina Luger and McCarthy, {Philip L.} and Milone, {Gustavo A.} and Santiago Pavlovsky and Phillips, {Gordon L.} and Russell, {James A.} and Saez, {Ruben A.} and Gary Schiller and Jorge Sierra and Weiner, {Roy S.} and Zander, {Axel R.} and Zhang, {Mei Jie} and Armand Keating and Weisdorf, {Daniel J.} and Horowitz, {Mary M.}",

note = "Funding Information: This work was supported by Public Health Service Grant U24-CA76518 from the National Cancer Institute, the National Institute of Allergy and Infectious Diseases, and the National Heart, Lung and Blood Institute; the Office of Naval Research; the Health Resources Services Administration (DHHS); AABB, Aetna; AIG Medical Excess; American Red Cross; Amgen; Inc.; an anonymous donation to the Medical College of Wisconsin; AnorMED, Inc.; Berlex Laboratories, Inc.; Biogen IDEC, Inc.; Blue Cross and Blue Shield Association; BRT Laboratories, Inc.; Celgene Corp.; Cell Therapeutics, Inc.; CelMed Biosciences; Cubist Pharmaceuticals; Dynal Biotech, LLC; Edwards Lifesciences RMI; Endo Pharmaceuticals, Inc.; Enzon Pharmaceuticals, Inc.; ESP Pharma; Fujisawa Healthcare, Inc.; Gambro BCT, Inc.; Genzyme Corporation; GlaxoSmithKline, Inc.; Histogenetics, Inc.; Human Genome Sciences; ILEX Oncology, Inc.; Kirin Brewery Company; Ligand Pharmaceuticals, Inc.; Merck & Company; Millennium Pharmaceuticals; Miller Pharmacal Group; Milliman USA, Inc.; Miltenyi Biotec; National Center for Biotechnology Information; National Leukemia Research Association; National Marrow Donor Program; NeoRx Corporation; Novartis Pharmaceuticals, Inc.; Novo Nordisk Pharmaceuticals; Ortho Biotech, Inc.; Osiris Therapeutics, Inc.; Pall Medical; Pfizer, Inc.; Pharmion Corp.; QOL Medical; Roche Laboratories; StemCyte, Inc.; Stemco Biomedical; StemSoft Software, Inc.; SuperGen, Inc.; Sysmex; The Marrow Foundation; THERAKOS, a Johnson & Johnson company; University of Colorado Cord Blood Bank; Valeant Pharmaceuticals; ViaCell, Inc.; ViraCor Laboratories; W.B. Saunders, Mosby, Churchill Livingstone; and Wellpoint Health Network. The contents of this article are the responsibility of the authors and do not represent the official views of the National Cancer Institute.",

year = "2006",

month = feb,

doi = "10.1016/j.bbmt.2005.10.013",

language = "English (US)",

volume = "12",

pages = "204--216",

journal = "Biology of Blood and Marrow Transplantation",

issn = "1083-8791",

publisher = "Elsevier Inc.",

number = "2",

}

TY - JOUR

T1 - Pretransplantation consolidation chemotherapy decreases leukemia relapse after autologous blood and bone marrow transplants for acute myelogenous leukemia in first remission

AU - Tallman, Martin S.

AU - Pérez, Waleska S.

AU - Lazarus, Hillard M.

AU - Gale, Robert Peter

AU - Maziarz, Richard T.

AU - Rowe, Jacob M.

AU - Marks, David I.

AU - Cahn, Jean Yves

AU - Bashey, Asad

AU - Bishop, Michael R.

AU - Christiansen, Neal

AU - Frankel, Stanley R.

AU - García, Juan J.

AU - Ilhan, Osman

AU - Laughlin, Mary J.

AU - Liesveld, Jane

AU - Linker, Charles

AU - Litzow, Mark R.

AU - Luger, Selina

AU - McCarthy, Philip L.

AU - Milone, Gustavo A.

AU - Pavlovsky, Santiago

AU - Phillips, Gordon L.

AU - Russell, James A.

AU - Saez, Ruben A.

AU - Schiller, Gary

AU - Sierra, Jorge

AU - Weiner, Roy S.

AU - Zander, Axel R.

AU - Zhang, Mei Jie

AU - Keating, Armand

AU - Weisdorf, Daniel J.

AU - Horowitz, Mary M.

N1 - Funding Information: This work was supported by Public Health Service Grant U24-CA76518 from the National Cancer Institute, the National Institute of Allergy and Infectious Diseases, and the National Heart, Lung and Blood Institute; the Office of Naval Research; the Health Resources Services Administration (DHHS); AABB, Aetna; AIG Medical Excess; American Red Cross; Amgen; Inc.; an anonymous donation to the Medical College of Wisconsin; AnorMED, Inc.; Berlex Laboratories, Inc.; Biogen IDEC, Inc.; Blue Cross and Blue Shield Association; BRT Laboratories, Inc.; Celgene Corp.; Cell Therapeutics, Inc.; CelMed Biosciences; Cubist Pharmaceuticals; Dynal Biotech, LLC; Edwards Lifesciences RMI; Endo Pharmaceuticals, Inc.; Enzon Pharmaceuticals, Inc.; ESP Pharma; Fujisawa Healthcare, Inc.; Gambro BCT, Inc.; Genzyme Corporation; GlaxoSmithKline, Inc.; Histogenetics, Inc.; Human Genome Sciences; ILEX Oncology, Inc.; Kirin Brewery Company; Ligand Pharmaceuticals, Inc.; Merck & Company; Millennium Pharmaceuticals; Miller Pharmacal Group; Milliman USA, Inc.; Miltenyi Biotec; National Center for Biotechnology Information; National Leukemia Research Association; National Marrow Donor Program; NeoRx Corporation; Novartis Pharmaceuticals, Inc.; Novo Nordisk Pharmaceuticals; Ortho Biotech, Inc.; Osiris Therapeutics, Inc.; Pall Medical; Pfizer, Inc.; Pharmion Corp.; QOL Medical; Roche Laboratories; StemCyte, Inc.; Stemco Biomedical; StemSoft Software, Inc.; SuperGen, Inc.; Sysmex; The Marrow Foundation; THERAKOS, a Johnson & Johnson company; University of Colorado Cord Blood Bank; Valeant Pharmaceuticals; ViaCell, Inc.; ViraCor Laboratories; W.B. Saunders, Mosby, Churchill Livingstone; and Wellpoint Health Network. The contents of this article are the responsibility of the authors and do not represent the official views of the National Cancer Institute.

PY - 2006/2

Y1 - 2006/2

N2 - Controversy exists over whether pretransplantation consolidation chemotherapy affects the outcome of subsequent autotransplantation for acute myelogenous leukemia (AML). The current study was undertaken to determine the association between previous consolidation and outcome of autotransplantation for AML in first remission. Posttransplantation outcomes of 146 patients receiving no consolidation were compared with those of 244 patients receiving standard-dose (<1 gm/m2) and 249 patients receiving high-dose (1-3 gm/m2) cytarabine, using proportional hazards regression to adjust for differences in prognostic variables. One-year transplantation-related mortality was similar among the cohorts. Five-year relapse rates were 49% (95% confidence interval CI = 39%-58%) with no consolidation, 35% (95% CI = 29%-42%) with standard-dose cytarabine, and 40% (95% CI = 33%-48%) with high-dose cytarabine (P = .07). Five-year leukemia-free survival rates were 39% (95% CI = 30%-47%) with no consolidation, 53% (95% CI = 46%-60%) with standard-dose cytarabine, and 48% (95% CI = 40%-56%) with high-dose cytarabine (P = .03). Similarly, 5-year overall survival was better in those patients receiving consolidation: 42% (95% CI = 34%-51%) with no consolidation, 59% (95% CI = 52%-65%) with standard-dose cytarabine, and 54% (95% CI = 46%-61%) with high-dose cytarabine (P = .01). Although most patients received 1 or 2 cycles of consolidation, the number of courses had no detectable effect on transplantation outcome. In multivariate analysis, risks of relapse and treatment failure were lower in the patients receiving consolidation, especially among those patients receiving blood cell grafts. Outcomes with standard-dose and high-dose cytarabine were similar. Based on our findings, we recommend that patients with AML in first remission receive consolidation before undergoing autotransplantation.

AB - Controversy exists over whether pretransplantation consolidation chemotherapy affects the outcome of subsequent autotransplantation for acute myelogenous leukemia (AML). The current study was undertaken to determine the association between previous consolidation and outcome of autotransplantation for AML in first remission. Posttransplantation outcomes of 146 patients receiving no consolidation were compared with those of 244 patients receiving standard-dose (<1 gm/m2) and 249 patients receiving high-dose (1-3 gm/m2) cytarabine, using proportional hazards regression to adjust for differences in prognostic variables. One-year transplantation-related mortality was similar among the cohorts. Five-year relapse rates were 49% (95% confidence interval CI = 39%-58%) with no consolidation, 35% (95% CI = 29%-42%) with standard-dose cytarabine, and 40% (95% CI = 33%-48%) with high-dose cytarabine (P = .07). Five-year leukemia-free survival rates were 39% (95% CI = 30%-47%) with no consolidation, 53% (95% CI = 46%-60%) with standard-dose cytarabine, and 48% (95% CI = 40%-56%) with high-dose cytarabine (P = .03). Similarly, 5-year overall survival was better in those patients receiving consolidation: 42% (95% CI = 34%-51%) with no consolidation, 59% (95% CI = 52%-65%) with standard-dose cytarabine, and 54% (95% CI = 46%-61%) with high-dose cytarabine (P = .01). Although most patients received 1 or 2 cycles of consolidation, the number of courses had no detectable effect on transplantation outcome. In multivariate analysis, risks of relapse and treatment failure were lower in the patients receiving consolidation, especially among those patients receiving blood cell grafts. Outcomes with standard-dose and high-dose cytarabine were similar. Based on our findings, we recommend that patients with AML in first remission receive consolidation before undergoing autotransplantation.

KW - Acute myelogenous leukemia

KW - Autologous

KW - Autotransplantation

KW - Consolidation

KW - Transplantation

UR - http://www.scopus.com/inward/record.url?scp=31344460389&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=31344460389&partnerID=8YFLogxK

U2 - 10.1016/j.bbmt.2005.10.013

DO - 10.1016/j.bbmt.2005.10.013

M3 - Article

C2 - 16443518

AN - SCOPUS:31344460389

SN - 1083-8791

VL - 12

SP - 204

EP - 216

JO - Biology of Blood and Marrow Transplantation

JF - Biology of Blood and Marrow Transplantation

IS - 2

ER -

Pretransplantation consolidation chemotherapy decreases leukemia relapse after autologous blood and bone marrow transplants for acute myelogenous leukemia in first remission

Abstract

Bibliographical note

Keywords

UN SDGs

Publisher link

Find It

Other files and links

Fingerprint

Cite this