Title :

Similar outcome of allogeneic stem cell transplantation after myeloablative and sequential conditioning regimen in patients with refractory or relapsed acute myeloid leukemia: A study from the Societe Francophone de Greffe de Moelle et de Therapie Cellulaire

Author(s) :

Decroocq, Justine [Auteur]
Itzykson, Raphael [Auteur]
Vigouroux, Stephane [Auteur]
Michallet, Mauricette [Auteur]
Yakoub-Agha, Ibrahim [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Huynh, Anne [Auteur]
Beckerich, Florence [Auteur]
Suarez, Felipe [Auteur]
Chevallier, Patrice [Auteur]
Nguyen-Quoc, Stephanie [Auteur]
Ledoux, Marie-Pierre [Auteur]
Clement, Laurence [Auteur]
Hicheri, Yosr [Auteur]
Guillerm, Gaelle [Auteur]
Cornillon, Jerome [Auteur]
Contentin, Nathalie [Auteur]
Carre, Martin [Auteur]
Maillard, Natacha [Auteur]
Mercier, Melanie [Auteur]
Mohty, Mohamad [Auteur]
Beguin, Yves [Auteur]
Bourhis, Jean-Henri [Auteur]
Charbonnier, Amandine [Auteur]
Dauriac, Charles [Auteur]
Bay, Jacques-Olivier [Auteur]
Blaise, Didier [Auteur]
Deconinck, Eric [Auteur]
Jubert, Charlotte [Auteur]
Raus, Nicole [Auteur]
Peffault De Latour, Regis [Auteur]
Dhedin, Nathalie [Auteur]

Journal title :

American Journal of Hematology

Abbreviated title :

Am. J. Hematol.

Volume number :

93

Pages :

416-423

Publication date :

2018-03

ISSN :

0361-8609

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Patients with acute myeloid leukemia (AML) in relapse or refractory to induction therapy have a dismal prognosis. Allogeneic hematopoietic stem cell transplantation is the only curative option. In these patients, we ...
Show more >Patients with acute myeloid leukemia (AML) in relapse or refractory to induction therapy have a dismal prognosis. Allogeneic hematopoietic stem cell transplantation is the only curative option. In these patients, we aimed to compare the results of a myeloablative transplant versus a sequential approach consisting in a cytoreductive chemotherapy followed by a reduced intensity conditioning regimen and prophylactic donor lymphocytes infusions. We retrospectively analyzed 99 patients aged 18-50 years, transplanted for a refractory (52%) or a relapsed AML not in remission (48%). Fifty-eight patients received a sequential approach and 41 patients a myeloablative conditioning regimen. Only 6 patients received prophylactic donor lymphocytes infusions. With a median follow-up of 48 months, 2-year overall survival was 39%, 95% confidence interval (CI) (24-53) in the myeloablative group versus 33%, 95% CI (21-45) in the sequential groups (P = .39), and 2-year cumulative incidence of relapse (CIR) was 57% versus 50% respectively (P = .99). Nonrelapse mortality was not higher in the myeloablative group (17% versus 15%, P = .44). In multivariate analysis, overall survival, CIR and nonrelapse mortality remained similar between the two groups. However, in multivariate analysis, sequential conditioning led to fewer acute grade II-IV graft versus host disease (GVHD) (HR for sequential approach = 0.37; 95% CI: 0.21-0.65; P < .001) without a significant impact on chronic GVHD (all grades and extensive). In young patients with refractory or relapsed AML, myeloablative transplant and sequential approach offer similar outcomes except for a lower incidence of acute GvHD after a sequential transplant.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Inserm
Université de Lille
CHU Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Research team(s) :

Immunity, inflammation and fibrsis in auto and allo-reactivity

Submission date :

2019-03-01T14:17:27Z
2024-01-23T12:23:21Z