Abstract
To assess the place of allogeneic hematopoietic stem cell transplantation (HSCT) in the advanced stage of acute myeloid leukemia (AML), we retrospectively analyzed 379 consecutive patients who underwent allogeneic HSCT for advanced AML. The median follow-up of the entire cohort was 7.5 years. Sixty-nine patients (18%) were transplanted with primary resistant disease. Three hundred and ten (82%) were relapsed patients, 94 (30%) of whom were in untreated relapse, 67 (22%) in refractory relapse and 149 (48%) in 2nd or 3rd complete remission at time of transplantation. The 5-year probabilities of overall survival (OS), disease-free survival (DFS), and transplant-related mortality (TRM) were 22 ± 4% 20 ± 4%, 45 ± 6%, respectively. In multivariate analysis, we demonstrated the favorable impact on OS, DFS and TRM of two factors over which we have no control (age <15 years, complete remission achievement) and three factors over which we have some control (female donor, acute and chronic graft-versus-host disease). The results of this study suggest that the graft-versus-leukemia effect is important in advanced AML and that new HSCT modalities are needed for some patients with this indication. Bone Marrow Transplantation (2000) 26, 1157–1163.
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Acknowledgements
We thank the following institutions: Hôpital Universitaire d'Angers (Angers), Hôpital Jean Minjoz (Besançon), Hôpital Haut Lévêque (Bordeaux), Höpital Universitaire de Caen (Caen), Hôpital de Percy (Clamart), Hôpital de l'Hôtel-Dieu (Clermont-Ferrand), Hôpital Henri Mondor (Créteil), Hôpital de Dijon (Dijon), Hôpital Michallon (Grenoble), Hôpital Huriez (Lille), Hôpital Debrousse (Lyon), Institut Paoli-Calmettes (Marseille), Hôpital Lapeyronie (Montpellier), Hôpital de Brabois (Nancy), Hôpital de l'Hôtel-Dieu (Nantes), Hôpital de l'Archet (Nice), Hôpital Cochin (Paris), Hôpital Hôtel-Dieu (Paris), Hôpital Necker Adultes (Paris), Hôpital Necker Enfants (Paris), Hôpital de la Pitié Salpêtrière (Paris), Hôpital Saint Louis (Paris), Institut Gustave Roussy (Paris), Hôpital Jean Bernard (Poitiers), Hôpital de Pontchaillon (Rennes), Hôpital Becquerel (Rouen), Hôpital Charles Nicolle (Rouen), Hôpital Nord (Saint-Etienne), Hôpital de Hautepierre (Strasbourg), Hôpital de Purpan (Toulouse), Hôpital Paul Brousse (Villejuif).
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Michallet, M., Thomas, X., Vernant, J. et al. Long-term outcome after allogeneic hematopoietic stem cell transplantation for advanced stage acute myeloblastic leukemia: a retrospective study of 379 patients reported to the Société Française de Greffe de Moelle (SFGM). Bone Marrow Transplant 26, 1157–1163 (2000). https://doi.org/10.1038/sj.bmt.1702690
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DOI: https://doi.org/10.1038/sj.bmt.1702690
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