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Transplant Outcomes

A prospective registration study to determine feasibility of hematopoietic SCT in adults with acute leukemia: planning, expectations and reality

Bone Marrow Transplantation volume 49, pages 376–381 (2014)Cite this article

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Abstract

For adults with acute leukemia, it is important to know whether the therapeutic schemes initially planned were actually implemented. The European Group for Blood and Marrow transplantation Acute Leukemia Working Party prospectively followed 695 consecutive patients who were registered at the time of HLA typing. Of 304 patients with an available matched sibling donor (MSD), SCT was planned in 264, chemotherapy in 33 and autografting in 7. For the rest, an unrelated donor (UD) search was initiated in 198. Among these, 117 were transplanted, 114 received chemotherapy and 77 underwent autografting. Probabilities of receiving a planned treatment were 60 and 65% at 1 and 2 years, respectively. Patients scheduled to receive MSD SCT had an 82% probability, whereas those scheduled to undergo UD SCT had a 57% probability, of receiving their transplant at 1 year. The only factor associated with a lower probability of MSD SCT in first remission was delayed HLA typing (HR=0.82; P=0.03). One year after enrollment, 40% of patients did not follow their initial treatment plan. Because OS was 50% only at 3 years and only 57% of the patients without a MSD underwent SCT, this suggests room for improvement in outcomes for adults with acute leukemia.

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Authors and Affiliations

  1. Paris EBMT Data Coordination Office, Hospital Saint-Antoine, APHP, Université Pierre et Marie Curie UPMC and INSERM U 938, Paris, France

    M Labopin, N-C Gorin, E Polge, M Mohty & V Rocha

  2. Department of Hematology and Cell Therapy, Hospital Saint-Antoine, Paris, France

    M Labopin, N-C Gorin & M Mohty

  3. Department of Hematology, APHP, Hospital Saint-Louis, University Paris VII, and Inserm U940, Paris, France

    G Socié

  4. Department of Hematology, Adult Stem Cell Transplantation Unit, Ankara University School of Medicine, Ankara, Turkey

    G Gurman

  5. and Haematology Department, Eurocord, Hospital Saint-Louis, Paris, France, Bone Marrow Transplant Unit, University of Oxford, Oxford, UK

    E Gluckman & V Rocha

  6. Department of Hematology/Oncology, Charles University Hospital, Pilsen, Czech Republic

    P Jindra

  7. Department of Hematology, Cliniques Universitaires Saint-Luc, Brussels, Belgium

    X Poiré

  8. Medizinische Klinik, BMT Unit, Nuremberg, Germany

    K Schäfer-Eckart

  9. Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland

    T Ruutu

  10. Divisione Clinicizzata di Ematologia, BMT unit, Ospedale Ferrarotto, Catania, Italy

    G Milone

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

    W Arcese

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  1. M Labopin
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  2. N-C Gorin
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  3. E Polge
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  5. G Gurman
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  9. K Schäfer-Eckart
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  10. T Ruutu
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  13. M Mohty
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  14. V Rocha
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on behalf of the Acute Leukemia Working Party (ALWP) of the European Group for Blood and Marrow transplantation (EBMT)

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Correspondence to N-C Gorin.

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Labopin, M., Gorin, NC., Polge, E. et al. A prospective registration study to determine feasibility of hematopoietic SCT in adults with acute leukemia: planning, expectations and reality. Bone Marrow Transplant 49, 376–381 (2014). https://doi.org/10.1038/bmt.2013.178

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