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Acute Leukemia

High numbers of mobilized CD34+ cells collected in AML in first remission are associated with high relapse risk irrespective of treatment with autologous peripheral blood SCT or autologous BMT

Bone Marrow Transplantation volume 50, pages 341–347 (2015)Cite this article

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Abstract

The faster hematopoietic recovery after autologous peripheral blood SCT (APBSCT) in patients with AML may be offset by an increased relapse risk as compared with autologous BMT (ABMT). The EORTC and GIMEMA Leukemia Groups conducted a trial (AML-10) in which they compared, as second randomization, APBSCT and ABMT in first CR patients without an HLA compatible donor. A total of 292 patients were randomized. The 5-year DFS rate was 41% in the APBSCT arm and 46% in the ABMT arm with a hazard ratio (HR) of 1.17; 95% confidence interval=0.85–1.59; P=0.34. The 5-year cumulative relapse incidence was 56% vs 49% (P=0.26), and the 5-year OS 50% and 55% (P=0.6) in the APBSCT and ABMT groups, respectively. APBSCT was associated with significantly faster recovery of neutrophils and platelets, shorter duration of hospitalization, reduced need of transfusion packed RBC and less days of intravenous antibiotics. In both treatment groups, higher numbers of mobilized CD34+ cells were associated with a significantly higher relapse risk irrespective of the treatment given after the mobilization. Randomization between APBSCT and ABMT did not result in significantly different outcomes in terms of DFS, OS and relapse incidence.

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Acknowledgements

This publication was supported by grants from the Fonds Cancer (FOCA) from Belgium and the Italian Association against Leukemias, Lymphoma and Myeloma. We acknowledge Saint Jude Children’s Research Hospital for providing of a SAS macro allowing the computation of the cumulative incidences of relapse and death in CR. We thank the EORTC Headquarters Data Managers who took care of this study (Mr Gabriel Solbu, Mrs Murielle Dardenne, Mrs Peggy Rodts, Mrs Goedele Eeckhout, Mrs Caroline Gilotay and Mr Stéphane Lejeune).

Author Contributions

SS, J-PM, PM, SA, BL, FM, AH, RW and TdW were involved in the conception and design of study. SS, PF and MV provided administrative support. YC, J-PM, PM, FL, FM, FP, SA, GF, BL, FB, JC, J-HB, GS, RW and TdW provided the study materials or patients. SS, PF and MV were involved in the collection and assembly of data. AH reviewed the cytogenetic data. MH, SS and TdW were involved in the data analysis and interpretation. MH, SS, J-PM, PM, SA, FB, MV, RW and TdW wrote the manuscript. All the authors gave final approval of the manuscript.

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Authors and Affiliations

  1. Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands

    M Hengeveld, P Muus & T de Witte

  2. EORTC Headquarters, Brussels, Belgium

    S Suciu

  3. CHU, Lyon, France

    Y Chelgoum

  4. Hôtel-Dieu, Paris, France

    J-P Marie

  5. Necker-Institut Curie, Paris, France

    F Lefrère

  6. Sapienza University, Roma, Italy

    F Mandelli

  7. Federico II University, Napoli, Italy

    F Pane

  8. Tor Vergata University Hospital, Roma, Italy

    S Amadori

  9. Ospedale Civile, Pescara, Italy

    G Fioritoni

  10. University Hospital Rebro, Zagreb, Croatia

    B Labar

  11. CHU Sart-Tilman, Liège, Belgium

    F Baron

  12. Institute Hematology, Prague, Czech Republic

    J Cermak

  13. Gustave Roussy Comprehensive Cancer Center, Villejuif, France,

    J-H Bourhis

  14. A.O.R.N. San Giuseppe Moscati, Avelino, Italy

    G Storti

  15. GIMEMA Data Center, Roma, Italy

    P Fazi & M Vignetti

  16. Universitair Ziekenhuis Gasthuisberg, Leuven, Belgium

    A Hagemeijer

  17. Leiden University Medical Center, Leiden, The Netherlands

    R Willemze

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  1. M Hengeveld
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Correspondence to T de Witte.

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Additional information

Results of the EORTC and GIMEMA AML-10 randomized phase III study.

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Hengeveld, M., Suciu, S., Chelgoum, Y. et al. High numbers of mobilized CD34+ cells collected in AML in first remission are associated with high relapse risk irrespective of treatment with autologous peripheral blood SCT or autologous BMT. Bone Marrow Transplant 50, 341–347 (2015). https://doi.org/10.1038/bmt.2014.262

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