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Long-term outcome of allogeneic transplants in acute myeloid leukemia

Leukemia volume 16, pages 751–752 (2002)Cite this article

What do we mean when we talk about the long-term outcome of bone marrow transplants for acute myeloid leukemia (AML)? The majority of studies present actuarial survival curves for the first 5 or at best 10 years after BMT. This presentation raises a number of questions: What is the actual long-term disease-related outcome after allogeneic BMT in AML? How does it compare to conservative treatments? Can survival plateaus be achieved? Finally, what is the functional capacity of long-term survival with AML?

To address these questions we initiated an intent-to-treat study of 135 AML patients that were referred to Princess Margaret Hospital between 1979 and 1993 for induction therapy. All age eligible patients were enrolled. During the study period the upper age limit was increased stepwise from 40 to 45, 50 and finally 55 years. Enrollment was completed in 1993 and the study evaluated in 1999, 20 years after treatment of the first patient. Out of the total 135 patients, 10 failed from early death, defined as having succumbed within the first 30 days after initiation of therapy. The remaining 125 patients and their families were tissue typed. Related donors were identified for 51/125 patients, and of these, 46 were transplanted. Twenty-four of 51 patients are alive. In contrast, only 14/74 of the patients without related donors are alive. The 10-year event-free survival (EFS) for patients with donors was 43%, compared to 14% for patients without donors. EFS for patients achieving a complete response (CR) were 52% and 20%, respectively. The EFS for patients transplanted in CR1 amounted to 70% at 10 years.1 The study demonstrated a significant long-term benefit for patients undergoing allogeneic transplant for their AML. The transplant was particularly beneficial for patients transplanted in CR1. These data raise the question, whether or not patients with related donors differ in their survival expectancy from patients without related donors.

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References

  1. Messner HA, Curtis JE, Lipton JL, Meharchand JM, Minden MD, Hao Y . Long-term benefits of allogeneic bone marrow transplants in the management of patients with acute myeloid leukemia: experience of a single center Blood 1999 94 (Suppl. 1): 166a (Abstr.)

    Google Scholar 

  2. Keating S, de Witte T, Suciu S et al. The influence of HLA-matched sibling donor availability on treatment outcome for patients with AML: an analysis of the AML 8A study of the EORTC Leukaemia Cooperative Group and GIMEMA. European Organization for Research and Treatment of Cancer. Gruppo Italiano Malattie Ematologiche Maligne dell'Adulto Br J Haematol 1998 102: 1344–1353

    Article  CAS  Google Scholar 

  3. Ferrant A, Labopin M, Frassoni F et al. Karyotype in acute myeloblastic leukemia: prognostic significance for bone marrow transplantation in first remission: a European Group for Blood and Marrow Transplantation study. Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation (EBMT) Blood 1997 90: 2931–2938

    CAS  PubMed  Google Scholar 

  4. Socie G, Stone JV, Wingard JR et al. Long-term survival and late deaths after allogeneic bone marrow transplantation N Engl J Med 1999 341: 14–21

    Article  CAS  Google Scholar 

  5. Duell T, van Lint MT, Ljungman P et al. Health and functional status of long-term survivors of bone marrow transplantation. EBMT Working Party on Late Effects and EULEP Study Group on Late Effects. European Group for Blood and Marrow Transplantation Ann Intern Med 1997 126: 184–192

    Article  CAS  Google Scholar 

  6. Kolb HJ, Socie G, Duell T et al. Malignant neoplasms in long-term survivors of bone marrow transplantation. Late Effects Working Party of the European Cooperative Group for Blood and Marrow Transplantation and the European Late Effect Project Group Ann Intern Med 1999 131: 738–744

    Article  CAS  Google Scholar 

  7. De Lima M, Strom SS, Keating M et al. Implications of potential cure in acute myelogenous leukemia: development of subsequent cancer and return to work Blood 1997 90: 4719–4724

    CAS  PubMed  Google Scholar 

  8. Nicholson HS, Fears TR, Byrne J . Death during adulthood in survivors of childhood and adolescent cancer Cancer 1994 73: 3094–3102

    Article  CAS  Google Scholar 

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  1. Department of Oncology and Hematology, University of Toronto, and Princess Margaret Hospital, Toronto, Ontario, Canada

    HA Messner

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This paper is part of a series of keynote addresses to be published in Leukemia. They were presented at the Acute Leukemia Forum, San Francisco, 20 April 2001. Supported by an unrestricted educational grant from Immunex.

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Messner, H. Long-term outcome of allogeneic transplants in acute myeloid leukemia. Leukemia 16, 751–752 (2002). https://doi.org/10.1038/sj.leu.2402463

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