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Comparative Study
. 2008 Feb;14(2):187-96.
doi: 10.1016/j.bbmt.2007.10.006. Epub 2007 Dec 20.

HLA-identical sibling allogeneic transplants versus chemotherapy in acute myelogenous leukemia with t(8;21) in first complete remission: collaborative study between the German AML Intergroup and CIBMTR

Richard F Schlenk  1 , Marcelo C Pasquini, Waleska S Pérez, Mei-Jie Zhang, Jürgen Krauter, Joseph H Antin, Asad Bashey, Brian J Bolwell, Thomas Büchner, Jean-Yves Cahn, Mitchell S Cairo, Edward A Copelan, Corey S Cutler, Hartmut Döhner, Robert Peter Gale, Osman Ilhan, Hillard M Lazarus, Jane L Liesveld, Mark R Litzow, David I Marks, Richard T Maziarz, Philip L McCarthy, Stephen D Nimer, Jorge Sierra, Martin S Tallman, Daniel J Weisdorf, Mary M Horowitz, Arnold Ganser; CIBMTR Acute Leukemia Working Committee
Affiliations
Comparative Study

HLA-identical sibling allogeneic transplants versus chemotherapy in acute myelogenous leukemia with t(8;21) in first complete remission: collaborative study between the German AML Intergroup and CIBMTR

Richard F Schlenk et al. Biol Blood Marrow Transplant. 2008 Feb.

Abstract

We studied the role of HLA-matched sibling hematopoietic cell transplantation (HCT) in treating t(8;21) acute myelogenous leukemia (AML) in first remission. Outcomes of 118 patients receiving HCT and reported to the Center for International Blood and Marrow Transplant Research were compared with 132 similar patients receiving chemotherapy selected from 8 German AML Intergroup multicenter trials. Characteristics of the cohorts were similar except that chemotherapy recipients were significantly older. To adjust for time to treatment bias, outcomes were compared using left-truncated Cox regression models. Transplants were associated with higher treatment-related mortality (TRM; relative risk [RR] 6.76, 95% confidence interval [CI] 2.95-15.45, P < .001), lower relapse (RR 0.47, 95% CI 0.25-0.85, P = .01), and similar relapse-free survival (P = .2). Loss of sex chromosomes (LOS) in addition to t(8;21) had a negative impact on overall survival (OS) in patients receiving chemotherapy. Patients without LOS experienced shorter survival after HCT comparing to chemotherapy (RR 3.05, P = .02), whereas patients with LOS had similar survival regardless of postremission therapy. In both cohorts, white blood cell count (WBC) at diagnosis >25 x 10(9)/L was associated with a higher relapse risk (RR = 2.09, P = .03), lower relapse-free (RR = 1.9, P = .008), and OS (RR = 1.91, P = .01). In this cohort of patients with t(8;21) AML, HCT did not improve OS, because reduction of relapse was offset by high TRM. In the group without LOS, survival after chemotherapy was far superior to HCT. These results suggest that patients with t(8;21) AML without poor prognostic factors have higher rates of survival after chemotherapy as a post remission therapy compared to HCT.

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Figures

Figure 1
Figure 1
Cumulative incidence of treatment related mortality after chemotherapy and HLA-matched sibling hematopoietic stem cell transplant for patients with t(8;21) AML in first complete remission, by postremission treatment.
Figure 2
Figure 2
Cumulative incidence of relapse after chemotherapy and HLA-matched sibling hematopoietic stem cell transplant for patients with t(8;21) AML in first complete remission, by postremission treatment.
Figure 3
Figure 3
Adjusted probability of relapse free survival after chemotherapy and HLA-matched sibling hematopoietic stem cell transplant for patients with t(8;21) AML in first complete remission., by postremission treatment.
Figure 4
Figure 4
Adjusted probability of overall survival after chemotherapy and HLA-matched sibling hematopoietic stem cell transplant for patients with t(8;21) AML in first complete remission, by postremission treatment and presence of sex chromosome.
See this image and copyright information in PMC

References

    1. Vardiman JW, Harris NL, Brunning RD. The World Health Organization (WHO) classification of the myeloid neoplasms 10.1182/blood-2002-04-1199. Blood. 2002;100:2292–2302. - PubMed
    1. Appelbaum FR, Kopecky KJ, Tallman MS, et al. The clinical spectrum of adult acute myeloid leukaemia associated with core binding factor translocations. Br J Haematol. 2006 - PubMed
    1. Marcucci G, Mrozek K, Ruppert AS, et al. Prognostic factors and outcome of core binding factor acute myeloid leukemia patients with t(8;21) differ from those of patients with inv(16): a Cancer and Leukemia Group B study. J Clin Oncol. 2005;23:5705–5717. - PubMed
    1. Schlenk RF, Benner A, Krauter J, et al. Individual patient data-based meta-analysis of patients aged 16 to 60 years with core binding factor acute myeloid leukemia: a survey of the German Acute Myeloid Leukemia Intergroup. J Clin Oncol. 2004;22:3741–3750. - PubMed
    1. Erickson P, Gao J, Chang KS, et al. Identification of breakpoints in t(8;21) acute myelogenous leukemia and isolation of a fusion transcript, AML1/ETO, with similarity to Drosophila segmentation gene, runt. Blood. 1992;80:1825–1831. - PubMed

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