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Clinical Trial
. 2010 Jul;24(7):1276-82.
doi: 10.1038/leu.2010.102. Epub 2010 May 20.

Comparison of matched unrelated and matched related donor myeloablative hematopoietic cell transplantation for adults with acute myeloid leukemia in first remission

R B Walter  1 , J M Pagel, T A Gooley, E W Petersdorf, M L Sorror, A E Woolfrey, J A Hansen, A I Salter, E Lansverk, F M Stewart, P V O'Donnell, F R Appelbaum
Affiliations
Clinical Trial

Comparison of matched unrelated and matched related donor myeloablative hematopoietic cell transplantation for adults with acute myeloid leukemia in first remission

R B Walter et al. Leukemia. 2010 Jul.

Abstract

Hematopoietic cell transplantation (HCT) from a matched related donor (MRD) benefits many adults with acute myeloid leukemia (AML) in first complete remission (CR1). The majority of patients does not have such a donor and will require an alternative donor if HCT is to be undertaken. We retrospectively analyzed 226 adult AML CR1 patients undergoing myeloablative unrelated donor (URD) (10/10 match, n=62; 9/10, n=29) or MRD (n=135) HCT from 1996 to 2007. The 5-year estimates of overall survival, relapse and nonrelapse mortality (NRM) were 57.9, 29.7 and 16.0%, respectively. Failure for each of these outcomes was slightly higher for 10/10 URD than MRD HCT, although statistical significance was not reached for any end point. The adjusted hazard ratios (HRs) were 1.43 (0.89-2.30, P=0.14) for overall mortality, 1.17 (0.66-2.08, P=0.60) for relapse and 1.79 (0.86-3.74, P=0.12) for NRM, respectively, and the adjusted odds ratio for grades 2-4 acute graft-versus-host disease was 1.50 (0.70-3.24, P=0.30). Overall mortality among 9/10 and 10/10 URD recipients was similar (adjusted HR 1.16 (0.52-2.61), P=0.71). These data indicate that URD HCT can provide long-term survival for CR1 AML; outcomes for 10/10 URD HCT, and possibly 9/10 URD HCT, suggest that this modality should be considered in the absence of a suitable MRD.

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Conflict of interest statement

CONFLICT OF INTEREST

The authors declare no competing financial interests.

Figures

Figure 1
Figure 1. Comparison of 10/10 URD, 9/10 URD, and MRD HCT
Estimate of the probability of OS (A), DFS (B) and relapse (C), for patients undergoing MRD HCT as compared to those undergoing 10/10 URD or 9/10 URD HCT.
Figure 1
Figure 1. Comparison of 10/10 URD, 9/10 URD, and MRD HCT
Estimate of the probability of OS (A), DFS (B) and relapse (C), for patients undergoing MRD HCT as compared to those undergoing 10/10 URD or 9/10 URD HCT.
Figure 1
Figure 1. Comparison of 10/10 URD, 9/10 URD, and MRD HCT
Estimate of the probability of OS (A), DFS (B) and relapse (C), for patients undergoing MRD HCT as compared to those undergoing 10/10 URD or 9/10 URD HCT.
Figure 2
Figure 2. Survival Following 10/10 URD or MRD HCT According to Cytogenetic Risk Group
Estimate of the probability of OS after 10/10 URD or MRD HCT for patients with either favorable/intermediate or unfavorable cytogenetics.
See this image and copyright information in PMC

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