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Clinical Trial
. 2011 Dec;17(12):1796-803.
doi: 10.1016/j.bbmt.2011.06.005. Epub 2011 Jun 21.

Comparison of reduced-intensity hematopoietic cell transplantation with chemotherapy in patients age 60-70 years with acute myelogenous leukemia in first remission

Sherif S Farag  1 , Kati Maharry, Mei-Jie Zhang, Waleska S Pérez, Stephen L George, Krzysztof Mrózek, John DiPersio, Donald W Bunjes, Guido Marcucci, Maria R Baer, Mitchell Cairo, Edward Copelan, Corey S Cutler, Luis Isola, Hillard M Lazarus, Mark R Litzow, David I Marks, Olle Ringdén, David A Rizzieri, Robert Soiffer, Richard A Larson, Martin S Tallman, Clara D Bloomfield, Daniel J Weisdorf; Acute Leukemia Committee of the Center for International Blood and Marrow Transplant Research and Cancer and Leukemia Group B
Collaborators, Affiliations
Clinical Trial

Comparison of reduced-intensity hematopoietic cell transplantation with chemotherapy in patients age 60-70 years with acute myelogenous leukemia in first remission

Sherif S Farag et al. Biol Blood Marrow Transplant. 2011 Dec.

Abstract

We compared the outcomes of patients age 60-70 years with acute myelogenous leukemia receiving reduced-intensity allogeneic hematopoietic cell transplantation (HCT) in first remission (CR1) reported to the Center for International Blood and Marrow Research (n = 94) with the outcomes in patients treated with induction and postremission chemotherapy on Cancer and Leukemia Group B protocols (n = 96). All patients included had been in CR1 for at least 4 months. The HCT recipients were slightly younger than the chemotherapy patients (median age, 63 years vs 65 years; P < .001), but there were no significant between-group differences in the proportion with therapy-related leukemia or in different cytogenetic risk groups. Time from diagnosis to CR1 was longer for the HCT recipients (median, 44 days vs 38 days; P = .031). Allogeneic HCT was associated with significantly lower risk of relapse (32% vs 81% at 3 years; P < .001), higher nonrelapse mortality (36% vs 4% at 3 years; P < .001), and longer leukemia-free survival (32% vs 15% at 3 years; P = .001). Although overall survival was longer for HCT recipients, the difference was not statistically significant (37% vs 25% at 3 years; P = .08). Our findings suggest that reduced-intensity conditioning allogeneic HCT in patients age 60-70 with acute myelogenous leukemia in CR1 reduces relapse and improves leukemia-free survival. Strategies that reduce nonrelapse mortality may yield significant improvements in overall survival.

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Figures

Figure 1
Figure 1
Cumulative incidence of non-relapse death in CR1
Figure 2
Figure 2
Cumulative incidence of relapse.
Figure 3
Figure 3
Leukemia-free survival.
Figure 4
Figure 4
Overall survival.
See this image and copyright information in PMC

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