Impact of conditioning regimen intensity on outcomes of second allogeneic hematopoietic cell transplantation for secondary acute myelogenous leukemia

Arnon Nagler¹, Christophe Peczynski², Bhagirathbhai Dholaria³, Myriam Labopin⁴, Thomas Valerius⁵, Peter Dreger⁶, Nicolaus Kröger⁷, Hans Christian Reinhardt⁸, Jürgen Finke⁹, Georg-Nikolaus Franke¹⁰, Fabio Ciceri¹¹, Mareike Verbeek¹², Igor Wolfgang Blau¹³, Martin Bornhäuser¹⁴, Alexandros Spyridonidis¹⁵, Gesine Bug¹⁶, Ali Bazarbachi¹⁷, Christophe Schmid¹⁸, Ibrahim Yakoub-Agha¹⁹, Bipin N Savani²⁰, Mohamad Mohty⁴

Affiliations

¹ Division of Hematology, Sheba Medical Center, Tel Hashomer, Israel.
² ALWP of the EBMT Paris office, Paris, France.
³ Vanderbilt University Medical Center, Nashville, TN, USA. Bhagirathbhai.r.dholaria@vumc.org.
⁴ Sorbonne University, Sevice d'hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, INSERM UMRs 938, Paris, France.
⁵ University Medical Center Schleswig Holstein, Campus Kiel, Section for Stem Cell Transplantation and Immunotherapy, Kiel, Germany.
⁶ University of Heidelberg, Medizinische Klinik u. Poliklinik V, Heidelberg, Germany.
⁷ University Hospital Eppendorf, Bone Marrow Transplantation Centre, Hamburg, Germany.
⁸ University Duisburg-Essen, University Hospital Essen, Dept. of Bone Marrow Hematology and Stem Cell Transplantation, Essen, Germany.
⁹ University of Freiburg, Dept. of Medicine -Hematology, Oncology, Freiburg, Germany.
¹⁰ Medical Clinic and Policinic 1, Hematology and Cellular Therapy, University Hospital Leipzig, Leipzig, Germany.
¹¹ Ospedale San Raffaele s.r.l., Haematology and BMT, Milano, Italy.
¹² Klinikum Rechts der Isar, III Med Klinik der TU, Munich, Germany.
¹³ Medizinische Klinik m. S. Hämatologie, Onkologie und Tumorimmunologie, Charité Universitätsmedizin, Berlin, Germany.
¹⁴ Universitaetsklinikum Dresden, Medizinische Klinik und Poliklinik I, Dresden, Germany.
¹⁵ Hematology Stem Cell Transplant Unit, School of Medicine, University of Patras, Patras, Greece.
¹⁶ Department of Medicine 2, Hematology and Oncology, Goethe University Frankfurt, Frankfurt, Germany.
¹⁷ Bone Marrow Transplantation Program, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
¹⁸ Department of Hematology and Oncology, University Hospital Augsburg, Augsburg, Germany.
¹⁹ CHU de Lille, Univ Lille, INSERM, U1285, Lille, France.
²⁰ Vanderbilt University Medical Center, Nashville, TN, USA.

PMID: 35501565
DOI: 10.1038/s41409-022-01693-8

Impact of conditioning regimen intensity on outcomes of second allogeneic hematopoietic cell transplantation for secondary acute myelogenous leukemia

Arnon Nagler et al. Bone Marrow Transplant. 2022 Jul.

. 2022 Jul;57(7):1116-1123.

doi: 10.1038/s41409-022-01693-8. Epub 2022 Apr 30.

Authors

Affiliations

¹ Division of Hematology, Sheba Medical Center, Tel Hashomer, Israel.
² ALWP of the EBMT Paris office, Paris, France.
³ Vanderbilt University Medical Center, Nashville, TN, USA. Bhagirathbhai.r.dholaria@vumc.org.
⁴ Sorbonne University, Sevice d'hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, INSERM UMRs 938, Paris, France.
⁵ University Medical Center Schleswig Holstein, Campus Kiel, Section for Stem Cell Transplantation and Immunotherapy, Kiel, Germany.
⁶ University of Heidelberg, Medizinische Klinik u. Poliklinik V, Heidelberg, Germany.
⁷ University Hospital Eppendorf, Bone Marrow Transplantation Centre, Hamburg, Germany.
⁸ University Duisburg-Essen, University Hospital Essen, Dept. of Bone Marrow Hematology and Stem Cell Transplantation, Essen, Germany.
⁹ University of Freiburg, Dept. of Medicine -Hematology, Oncology, Freiburg, Germany.
¹⁰ Medical Clinic and Policinic 1, Hematology and Cellular Therapy, University Hospital Leipzig, Leipzig, Germany.
¹¹ Ospedale San Raffaele s.r.l., Haematology and BMT, Milano, Italy.
¹² Klinikum Rechts der Isar, III Med Klinik der TU, Munich, Germany.
¹³ Medizinische Klinik m. S. Hämatologie, Onkologie und Tumorimmunologie, Charité Universitätsmedizin, Berlin, Germany.
¹⁴ Universitaetsklinikum Dresden, Medizinische Klinik und Poliklinik I, Dresden, Germany.
¹⁵ Hematology Stem Cell Transplant Unit, School of Medicine, University of Patras, Patras, Greece.
¹⁶ Department of Medicine 2, Hematology and Oncology, Goethe University Frankfurt, Frankfurt, Germany.
¹⁷ Bone Marrow Transplantation Program, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
¹⁸ Department of Hematology and Oncology, University Hospital Augsburg, Augsburg, Germany.
¹⁹ CHU de Lille, Univ Lille, INSERM, U1285, Lille, France.
²⁰ Vanderbilt University Medical Center, Nashville, TN, USA.

PMID: 35501565
DOI: 10.1038/s41409-022-01693-8

Erratum in

Correction to: Impact of conditioning regimen intensity on outcomes of second allogeneic hematopoietic cell transplantation for secondary acute myelogenous leukemia.
Nagler A, Peczynski C, Dholaria B, Labopin M, Valerius T, Dreger P, Kröger N, Reinhardt HC, Finke J, Franke GN, Ciceri F, Verbeek M, Blau IW, Bornhäuser M, Spyridonidis A, Bug G, Bazarbachi A, Schmid C, Yakoub-Agha I, Savani BN, Mohty M. Nagler A, et al. Bone Marrow Transplant. 2022 Dec;57(12):1854. doi: 10.1038/s41409-022-01834-z. Bone Marrow Transplant. 2022. PMID: 36207624 No abstract available.

Abstract

Limited data is available on factors impacting the outcomes of second hematopoietic cell transplantation (HCT2) in patients with secondary acute myeloid leukemia (sAML). This study aimed to assess HCT2 outcome for sAML comparing reduced-intensity (RIC) to myeloablative (MAC) conditioning. Two hundred and fifteen patients were included: RIC (n = 134), MAC (n = 81). The median follow-up was 41.1 (95% CI: 26.7-69.3) and 28.5 (95% CI: 23.9-75.4) months, respectively. At two years, the relapse incidence (RI) was 58.3% versus 51.1% in RIC and MAC, respectively. The 2-year leukemia free survival (LFS) was 26.6% versus 26%, and the graft-versus-host disease (GVHD)-free, relapse-free survival (GRFS) was 16.4% versus 12.1%, while OS was 31.4% and 39.7%, for RIC and MAC respectively. MVA showed a significantly lower RI [hazard ratio (HR) = 0.46 (95% CI, 0.26-0.8, p = 0.006)] and improved LFS [HR = 0.62 (95% CI, 0.39-0.98, p = 0.042)] with MAC versus RIC. The choice of conditioning regimen did not impact non-relapse mortality [HR = 1.14 (95% CI, 0.52-2.5, p = 0.74)], overall survival (OS) [HR = 0.72 (95% CI, 0.44-1.17, p = 0.18)] or GRFS [HR = 0.89 (95% CI, 0.59-1.36, p = 0.6)]. In conclusion, MAC was associated with a lower RI and superior LFS. These results support the use of MAC for eligible patients with sAML who are being considered for HCT2.

PubMed Disclaimer

References

1. Granfeldt Ostgard LS, Medeiros BC, Sengelov H, Norgaard M, Andersen MK, Dufva IH, et al. Epidemiology and clinical significance of secondary and therapy-related acute myeloid leukemia: a National population-based cohort study. J Clin Oncol. 2015;33:3641–9. https://doi.org/10.1200/jco.2014.60.0890 . - DOI - PubMed
1. Hulegårdh E, Nilsson C, Lazarevic V, Garelius H, Antunovic P, Rangert Derolf Å, et al. Characterization and prognostic features of secondary acute myeloid leukemia in a population-based setting: a report from the Swedish Acute Leukemia Registry. Am J Hematol. 2015;90:208–14. https://doi.org/10.1002/ajh.23908 . - DOI - PubMed
1. Della Porta MG. Prognosis of secondary acute myeloid leukemia. Leuk Res. 2013;37:857–8. https://doi.org/10.1016/j.leukres.2013.04.016 . - DOI - PubMed
1. Park SH, Chi H-S, Cho Y-U, Jang S, Park C-J. Evaluation of prognostic factors in patients with therapy-related acute myeloid leukemia. Blood Res. 2013;48:185 https://doi.org/10.5045/br.2013.48.3.185 . - DOI - PubMed - PMC
1. Christiansen DH, Andersen MK, Pedersen-Bjergaard J. Mutations with loss of heterozygosity of p53 are common in therapy-related myelodysplasia and acute myeloid leukemia after exposure to alkylating agents and significantly associated with deletion or loss of 5q, a complex karyotype, and a poor prognosis. J Clin Oncol. 2001;19:1405–13. https://doi.org/10.1200/jco.2001.19.5.1405 . - DOI - PubMed

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

LinkOut - more resources

Full Text Sources
- Nature Publishing Group
Medical
- MedlinePlus Health Information

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Impact of conditioning regimen intensity on outcomes of second allogeneic hematopoietic cell transplantation for secondary acute myelogenous leukemia

Affiliations

Impact of conditioning regimen intensity on outcomes of second allogeneic hematopoietic cell transplantation for secondary acute myelogenous leukemia

Authors

Affiliations

Erratum in

Abstract

References

MeSH terms

LinkOut - more resources

Full Text Sources

Medical