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Acute myeloid leukemia

Allogeneic haemopoietic transplantation for acute myeloid leukaemia in second complete remission: a registry report by the Acute Leukaemia Working Party of the EBMT

Leukemia volume 34, pages 87–99 (2020)Cite this article

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Abstract

Allogeneic haemopoietic cell transplant (allo-HCT) may be curative in acute myeloid leukaemia (AML) in second complete remission (CR2) but the impact of reduced intensity (RIC) versus myeloablative conditioning (MAC) is uncertain. The Acute Leukaemia Working Party of the European Society for Blood and Bone Marrow Transplantation Registry studied an AML CR2 cohort characterised by age ≥ 18 years, first allo-HCT 2007–2016, available cytogenetic profile at diagnosis, donors who were matched family, volunteer unrelated with HLA antigen match 10/10 or 9/10 or haplo-identical. The 1879 eligible patients included 1010 (54%) MAC allo-HCT recipients. In patients <50 years (y), two year outcomes for MAC vs RIC allo-HCT were equivalent with leukaemia-free survival (LFS) 54% for each, overall survival (OS), 61% vs 62%, non-relapse mortality (NRM) 18% vs 15% and graft versus host disease relapse-free survival (GRFS) 38% vs 42%. In patients ≥50 y, 2 y outcomes for MAC vs RIC allo-HCT were equivalent for LFS 52% vs 49%, OS 58% vs 55% and GRFS 42.4% vs 36%. However, NRM was significantly inferior after MAC allo-HCT, 27% vs 19% (P = 0.01) despite worse cGVHD after RIC-allo (32% vs 39%). These data support the need for ongoing prospective study of conditioning intensity and GVHD mitigation in AML.

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Acknowledgements

We thank all European Group for Blood and Marrow Transplantation (EBMT) centres and national registries for contributing patients to the study and data managers for their superb work. The study was supported by the European Blood & Marrow Transplantation funded by annual subscription from the constituent transplant centres.

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Authors and Affiliations

  1. Department of Haematology, Leeds Teaching Hospitals Trust, Leeds, UK

    Maria H. Gilleece

  2. EBMT Paris study office/CEREST-TC, Paris, France

    Myriam Labopin

  3. Division of Hematology/Oncology, Vanderbilt University Medical Center, Nashville, TN, USA

    Bipin N. Savani

  4. CHU de Lille, LIRIC, INSER U995, Université de Lille, Lille, France

    Ibrahim Yakoub-Agha

  5. Hematologie / Transplantation, Hôpital St Louis, Paris, CEDEX 10, France

    Gerard Socié

  6. Section for Hematology, Oslo University Hospital, Rikshospitalet, Oslo, Norway

    Tobias Gedde-Dahl

  7. Programme de Transplantation & Therapie Cellulaire, Centre de Recherche en Cancérologie de Marseille, Institut Paoli Calmettes, Marseille, France

    Didier Blaise

  8. Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK

    Jennifer L. Byrne

  9. Queen Elizabeth Medical Centre, University Hospital Birmingham NHS Trust, Department of Haematology, Birmingham, UK

    Charles Craddock

  10. Erasmus MC Cancer Institute, University Medical Center Rotterdam, Department of Haematology, Rotterdam, Netherlands

    Jan J. Cornelissen

  11. Tor Vergata University of Rome, Policlinico Universitario Tor Vergata, Stem Cell Transplant Unit, Rome, Italy

    William Arcese

  12. Service Hématologie Clinique et Thérapie Cellulaire, Hôpital Haut-Lévêque – CHU, Bordeaux, France

    Edouard Forcade

  13. Addenbrookes Hospital, Department of Haematology, Cambridge, UK

    Charles Crawley

  14. Acute Leukemia Working Party, European Society for Blood and Marrow Transplantation Paris Study Office/European Center for Biostatistical and Epidemiological Evaluation in Hematopoietic Cell Therapy (CEREST-TC), Paris, France

    Emmanuelle Polge

  15. Hôpital Saint Antoine, INSERM UMR 938, Paris, France

    Mohamad Mohty

  16. Université Pierre et Marie Curie, Paris, France

    Mohamad Mohty

  17. Hematology Division, Chaim Sheba Medical Center, Tel Hashomer, Israel

    Arnon Nagler

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  1. Maria H. Gilleece
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Correspondence to Maria H. Gilleece.

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MHG—Travel grant, advisory board and speaker fees—Jazz. BS—Honoraria from JAZZ Pharmaceuticals and Therakos. JB—advisory board and speaker fees—Pfizer, Novartis and Jazz. EF—Travel grant—Neovil; Scientific expert—Novartis. The other authors declare that they have no conflict of interest.

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Gilleece, M.H., Labopin, M., Savani, B.N. et al. Allogeneic haemopoietic transplantation for acute myeloid leukaemia in second complete remission: a registry report by the Acute Leukaemia Working Party of the EBMT. Leukemia 34, 87–99 (2020). https://doi.org/10.1038/s41375-019-0527-4

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