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Acute Leukemias

Early related or unrelated haematopoietic cell transplantation results in higher overall survival and leukaemia-free survival compared with conventional chemotherapy in high-risk acute myeloid leukaemia patients in first complete remission

Leukemia volume 23, pages 635–640 (2009)Cite this article

Abstract

Between 1996 and 2004, a total of 708 patients were enrolled in the acute myeloid leukaemia (AML) ‘96 and ‘02 studies of the East German Study Group (OSHO). Of these, 138 patients (19.5%) had unfavourable cytogenetics defined as complex karyotype, del (5q)/-5, del (7q)/-7, abn (3q26) and abn (11q23). In all, 77 (56%) achieved complete remission 1 (CR1) after induction chemotherapy and were eligible for haematopoietic cell transplantation (HCT). HCT was performed after a median of two cycles of consolidation chemotherapy (CT) in the AML ‘96 and one cycle in the AML ‘02 study (P=0.03). After a median follow-up of 19 months, overall survival (OS) at two years was significantly better in the donor group (52±9%) versus the no-donor group (24±8%; P=0.005). Differences in outcomes were mainly because of a lower relapse incidence in patients after HCT (39±11%) compared with a higher relapse incidence in patients undergoing CT (77±10%; P=0.0005). Treatment-related mortality was low and not statistically significantly different between the two treatment groups (15±7 and 5±5% for HCT and chemotherapy, respectively; P=0.49).We conclude that early HCT from related or unrelated donors led to significantly better OS and leukaemia-free survival compared with chemotherapy in patients with unfavourable karyotype.

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Author notes

  1. F Kamprad: In memoriam

Authors and Affiliations

  1. Department of Hematology and Oncology, University Medical School, Leipzig, Germany

    N Basara, C Becker, S Heyn, C Kliem, T Lange, R Krahl, W Pönisch, H Al-Ali & D Niederwieser

  2. Department of Hematology/Oncology HELIOS Clinic, Erfurt, Germany

    A Schulze

  3. Friedrich Schiller University, Jena, Germany

    U Wedding, H-J Fricke & H G Sayer

  4. Otto-von-Guericke University, Magdeburg, Germany

    M Mohren

  5. Department of Hematology/Oncology, Clinic Ernst von Bergmann, Potsdam, Germany

    A Gerhardt

  6. Department of Hematology and Oncology, University of Rostock, Rostock, Germany

    C Junghanss

  7. Carl-Thiem-Clinic, Cottbus, Germany

    N Peter

  8. Ernst-Moritz-Arndt University, Greifswald, Germany

    G Dölken

  9. Department of Radiotherapy, University Medical School, Leipzig, Germany

    F Kamprad

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Correspondence to D Niederwieser.

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Basara, N., Schulze, A., Wedding, U. et al. Early related or unrelated haematopoietic cell transplantation results in higher overall survival and leukaemia-free survival compared with conventional chemotherapy in high-risk acute myeloid leukaemia patients in first complete remission. Leukemia 23, 635–640 (2009). https://doi.org/10.1038/leu.2008.352

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