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Allografting

The impact of center experience on results of reduced intensity: allogeneic hematopoietic SCT for AML. An analysis from the Acute Leukemia Working Party of the EBMT

Bone Marrow Transplantation volume 48, pages 238–242 (2013)Cite this article

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Abstract

Allogeneic hematopoietic SCT with reduced-intensity conditioning (RIC-HSCT) is increasingly adopted for the treatment of older adults with AML. Our goal was to verify for the first time, if center experience influences outcome of RIC-HSCT. Results of 1413 transplantations from HLA-matched related or unrelated donors for adult patients with AML in first CR were analyzed according to the level of center activity. Transplants were performed in 203 European centers between 2001 and 2007. The 2-year probability of leukemia-free survival (LFS) after RIC-HSCT performed in centers with the lowest activity (⩽15 procedures/7 years) was 43±3% compared with 55±2% in the remainder (P<0.001). The incidence of non-relapse mortality (NRM) was 24±3% and 15±1% (P=0.004), whilst relapse rate was 33±3% and 31±1% (P=0.33), respectively. In a multivariate model, adjusted for other prognostic factors, low RIC-HSCT activity was associated with decreased chance of LFS (hazard ratio (HR)=0.64; P<0.001) and increased risk of NRM (HR=1.47, P=0.04) and relapse (HR=1.41, P=0.01). Center experience is a very important predictor of outcome and should be considered in future analyses evaluating the results of RIC-HSCT. The reasons why centers with low RIC-HSCT activity have worse outcomes should be further investigated.

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Authors and Affiliations

  1. Department of Bone Marrow Transplantation, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Gliwice Branch, Gliwice, Poland

    S Giebel & M Sadus-Wojciechowska

  2. Acute Leukemia Working Party of the EBMT, Faculté de Médicine Saint-Antoine 27, Paris, France

    M Labopin

  3. Department D’Hematologie, CHU Nantes, Nantes, France

    M Mohty

  4. Department of Haematological Medicine, GKT School of Medicine, King’s Denmark Hill Campus, London, UK

    G J Mufti

  5. Division of Hematology, Oncology and Hemostasiology, University Hospital Leipzig, Leipzig, Germany

    D Niederwieser

  6. Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam, The Netherlands

    J J Cornelissen

  7. Department of Hematology, VU University Medical Center, Amsterdam, The Netherlands

    J J W M Janssen

  8. CHU Bordeaux, Hôpital Haut-leveque, Pessac, France

    N Milpied

  9. BMT Unit Department of Hematology, Rigshospitalet, Copenhagen, Denmark

    L Vindelov

  10. Department of Hematology, University Medical Centre, Utrecht, The Netherlands

    E Petersen

  11. Medizinische Klinik m. S. Hämatologie/Onkologie, Charité Universitätsmedizin Berlin, Campus Virchow Klinikum, Berlin, Germany

    R Arnold

  12. Department of Hematology II, Ospedale San Martino, Genova, Italy

    A Bacigalupo & F Frassoni

  13. Unité de transplantation et de thérapie cellulaire, Inserm UMR 891, Institut Paoli Calmettes, Marseille, France

    D Blaise

  14. Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, UK

    C Craddock

  15. Chaim Sheba Medical Center, Tel-Hashomer, Israel

    A Nagler

  16. Hopital St Louis, Paris, France

    V Rocha

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  1. S Giebel
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  2. M Labopin
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  4. G J Mufti
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  5. D Niederwieser
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  6. J J Cornelissen
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  7. J J W M Janssen
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  8. N Milpied
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  9. L Vindelov
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  10. E Petersen
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  11. R Arnold
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  12. A Bacigalupo
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  13. D Blaise
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  14. C Craddock
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  15. A Nagler
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  16. F Frassoni
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  17. M Sadus-Wojciechowska
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  18. V Rocha
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Correspondence to S Giebel.

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Giebel, S., Labopin, M., Mohty, M. et al. The impact of center experience on results of reduced intensity: allogeneic hematopoietic SCT for AML. An analysis from the Acute Leukemia Working Party of the EBMT. Bone Marrow Transplant 48, 238–242 (2013). https://doi.org/10.1038/bmt.2012.131

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