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Superior transplantation outcomes of 8/8‐matched unrelated donors as well as matched siblings to autologous transplantation for acute myeloid leukemia with intermediate cytogenetics in first remission
Author(s) -
Cho ByungSik,
Kim JungHo,
Yoon JaeHo,
Shin SeungHwan,
Yahng SeungAh,
Lee SungEun,
Eom KiSeong,
Kim YooJin,
Lee Seok,
Min ChangKi,
Cho SeokGoo,
Kim DongWook,
Lee JongWook,
Min WooSung,
Park ChongWon,
Kim HeeJe
Publication year - 2013
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.12089
Subject(s) - transplantation , cytogenetics , medicine , myeloid leukemia , oncology , leukemia , gastroenterology , myeloid , biology , chromosome , genetics , gene
Objectives For patients with acute myeloid leukemia in first complete remission ( AML CR 1) lacking HLA ‐matched sibling donors ( MSD ), 8/8‐matched unrelated donors ( URD ) are mostly used in cases with poor‐risk features. For AML CR 1 with intermediate cytogenetics, however, the benefit of 8/8‐matched URD should be compared with non‐allogeneic therapies as well as MSD . Methods To address this issue, we assessed the transplantation outcomes of 8/8‐matched URD ( n = 54) compared with MSD ( n = 145) or autologous transplantation ( n = 89) for AML CR 1 with intermediate cytogenetics. Results In multivariate analyses, 8/8‐matched URD had comparable 6‐yr overall survival (OS, P = 0.997), disease‐free survival ( DFS , P = 0.951), and relapse ( P = 0.672) to MSD , whereas 8/8‐matched URD had a higher OS ( P = 0.070) and DFS ( P = 0.035) with lower relapse ( P = 0.009) than autologous transplantation. No difference in non‐relapse mortality was observed according to donor type. Notably, these equivalent or superior outcomes of 8/8‐matched URD compared with MSD or autologous transplantation, respectively, were particularly evident in patients without poor‐risk features ( n = 200), such as older age, hyperleukocytosis at diagnosis, and myelodysplasia‐related changes, who are not usual candidates for URD transplantation. Conclusions These results indicate that 8/8‐matched URD are feasible next option in AML CR 1 with intermediate cytogenetics, when lacking MSD , even in patients without poor‐risk features.