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Extramedullary relapses after allogeneic stem cell transplantation for acute myeloid leukemia: clinical characteristics, incidence, risk factors and outcomes

Bone Marrow Transplantation volume 53, pages 838–843 (2018)Cite this article

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Abstract

Acute myeloid leukemia (AML) relapse after allogeneic hematopoietic cell transplant (allo-HCT) is challenging. Data on extramedullary relapse (EMR) after allo-HCT are limited. We analyzed 215 patients with AML who underwent allo-HCT in our institution between January 2005 and December 2015. We limited this retrospective review to patients who received a MA conditioning, were in complete remission (CR) at the time of transplant and who received a matched sibling transplant, all other patients were excluded to avoid heterogeneity. Seventy-seven (35.8%) patients experienced disease relapse, 45 had BMR, and 32 had EMR. The only variable that was statistically associated with EMR post allo-HCT was male sex (OR = 3.2 (1.2, 8.2), p-value = 0.01); there was a trend for association between transplant in >CR2 and EMR (OR = 0.38 (0.14, 1.06), p-value = 0.06). The median overall survival (OS) after relapse for all relapses was 10 months (95% CI 4.839–15.161). The median OS for BMR group was 8 months (95% CI 2.850–13.150) and 14 months for the EMR group (95% CI 5.776–22.224); however, this was not statistically significant, p-value = 0.4. Multivariate analysis revealed that gender, treatment modality, and time from allo-HCT to relapse (≥12 vs. <12 months) have significant association with the post-relapse death. Male gender was the only significant factor associated with EMR.

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  1. Adult Hematology, Bone Marrow Transplantation, Oncology Center, MBC 64, King Faisal Specialist Hospital and Research Center, POB 3354, Riyadh, 11211, Saudi Arabia

    Noura Alhashim, Mahmoud Aljurf, Mona Hassanein, Naeem Chaudhri, Shahrukh Hashmi, Ghada El-Gohary, Fahad Alsharif, Maamoun Alsermani, Muhned Alhumaid, Amal Al Beihany, Marwan Shaheen, Amr Hanbali, Feras Alfraih, Said Mohamed, Hazzaa Alzahrani, Tusneem Elhassan, Abdelmoneim Eldali, Walid Rasheed, Syed Ahmed, Fahad Almohareb & Riad El Fakih

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Correspondence to Riad El Fakih.

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Alhashim, N., Aljurf, M., Hassanein, M. et al. Extramedullary relapses after allogeneic stem cell transplantation for acute myeloid leukemia: clinical characteristics, incidence, risk factors and outcomes. Bone Marrow Transplant 53, 838–843 (2018). https://doi.org/10.1038/s41409-018-0093-9

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