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Autografting

High probability of long-term survival in 2-year survivors of autologous hematopoietic cell transplantation for AML in first or second CR

Abstract

We describe the long-term outcomes of autologous hematopoietic cell transplantation (HCT) for 315 AML patients in first or second complete remission (CR). All patients were in continuous CR for 2 years after HCT. Patients were predominantly transplanted in CR1 (78%) and had good or intermediate cytogenetic risk disease (74%). Median follow-up of survivors was 106 (range, 24–192) months. Overall survival at 10 years after HCT was 94% (95% confidence intervals, 89–97%) and 80% (67–91%) for patients receiving HCT in CR1 and CR2, respectively. The cumulative incidence of relapse at 10 years after HCT was 6% (3–10%) and 10% (3–20%) and that of nonrelapse mortality was 5% (2–9%) and 11% (4–21%), respectively. On multivariate analysis, HCT in CR2 (vs CR1), older age at transplantation and poor cytogenetic risk disease were independent predictors of late mortality and adverse disease-free survival. The use of growth factors to promote engraftment after HCT was the only risk factor for relapse. Relative mortality of these 2-year survivors was comparable to that of age-, race- and gender-matched normal population. Patients who receive autologous HCT for AML in CR1 or CR2 and remain in remission for 2 years have very favorable long-term survival. Their mortality rates are similar to that of the general population.

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Acknowledgements

The CIBMTR is supported by the Public Health Service Grant/Cooperative Agreement U24-CA76518 from the National Cancer Institute (NCI), the National Heart, Lung and Blood Institute (NHLBI) and the National Institute of Allergy and Infectious Diseases (NIAID); a Grant/Cooperative Agreement 5U01HL069294 from NHLBI and NCI; a contract HHSH234200637015C with Health Resources and Services Administration (HRSA/DHHS); two Grants N00014-06-1-0704 and N00014-08-1-0058 from the Office of Naval Research; and grants from AABB; Aetna; American Society for Blood and Marrow Transplantation; Amgen, Inc; Anonymous donation to the Medical College of Wisconsin; Astellas Pharma US, Inc; Baxter International, Inc; Bayer HealthCare Pharmaceuticals; Be the Match Foundation; Biogen IDEC; BioMarin Pharmaceutical, Inc; Biovitrum AB; BloodCenter of Wisconsin; Blue Cross and Blue Shield Association; Bone Marrow Foundation; Canadian Blood and Marrow Transplant Group; CaridianBCT; Celgene Corporation; CellGenix, GmbH; Centers for Disease Control and Prevention; Children's Leukemia Research Association; ClinImmune Labs; CTI Clinical Trial and Consulting Services; Cubist Pharmaceuticals; Cylex Inc; CytoTherm; DOR BioPharma, Inc; Dynal Biotech, an Invitrogen Company; Eisai, Inc; Enzon Pharmaceuticals, Inc; European Group for Blood and Marrow Transplantation; Gamida Cell, Ltd; GE Healthcare; Genentech, Inc; Genzyme Corporation; Histogenetics, Inc; HKS Medical Information Systems; Hospira, Inc; Infectious Diseases Society of America; Kiadis Pharma; Kirin Brewery Co., Ltd; The Leukemia & Lymphoma Society; Merck & Company; The Medical College of Wisconsin; MGI Pharma, Inc; Michigan Community Blood Centers; Millennium Pharmaceuticals, Inc; Miller Pharmacal Group; Milliman USA, Inc; Miltenyi Biotec, Inc; National Marrow Donor Program; Nature Publishing Group; New York Blood Center; Novartis Oncology; Oncology Nursing Society; Osiris Therapeutics, Inc; Otsuka America Pharmaceutical, Inc; Pall Life Sciences; Pfizer Inc; Saladax Biomedical, Inc; Schering Corporation; Society for Healthcare Epidemiology of America; StemCyte, Inc; StemSoft Software, Inc; Sysmex America, Inc; Teva Pharmaceutical Industries; THERAKOS, Inc; Thermogenesis Corporation; Vidacare Corporation; Vion Pharmaceuticals, Inc; ViraCor Laboratories; ViroPharma, Inc; and Wellpoint, Inc. The views expressed in this article do not reflect the official policy or position of the National Institute of Health, the Department of the Navy, the Department of Defense, or any other agency of the US Government.

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Majhail, N., Bajorunaite, R., Lazarus, H. et al. High probability of long-term survival in 2-year survivors of autologous hematopoietic cell transplantation for AML in first or second CR. Bone Marrow Transplant 46, 385–392 (2011). https://doi.org/10.1038/bmt.2010.115

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