Long-term survival after allogeneic haematopoietic cell transplantation for AML in remission: single-centre results after TBI-based myeloablative and non-myeloablative conditioning

Bone Marrow Transplant. 2013 Sep;48(9):1185-91. doi: 10.1038/bmt.2013.38. Epub 2013 Mar 25.

Abstract

We report the results of non-myeloablative (NM) and myeloablative (MA) conditioning for haematopoietic cell transplantation in 207 consecutive AML patients at a single institution. A total of 122 patients were transplanted in first CR (CR1) and 67 in second CR (CR2). MA conditioning was given to 60 patients in CR1 and 50 in CR2. NM conditioning was given to 62 patients in CR1 and 17 patients in CR2. MA patients in CR1 experienced more acute GVHD than NM patients, 60.5% versus 22.9%, but the 5-year post transplant cumulative TRM was not different. Relapse incidence at 5 years in CR1 patients was 23.7% which is not statistically different from 28.5% in NM patients. Leukaemia-free survival at 5 years in CR1 patients was 57.7% after MA conditioning and 58.3% after NM conditioning. No statistical difference in overall 5-year survival after MA or NM conditioning was observed in CR1 patients (63.9 versus 64%) and CR2 patients (51.2 versus 64.7%). Durable remission can be obtained in older patients with AML in remission after NM conditioning, which may also be applicable to younger patients.

MeSH terms

  • Adolescent
  • Adult
  • Combined Modality Therapy
  • Cyclophosphamide / administration & dosage
  • Female
  • Hematopoietic Stem Cell Transplantation / methods*
  • Humans
  • Leukemia, Myeloid, Acute / drug therapy
  • Leukemia, Myeloid, Acute / radiotherapy
  • Leukemia, Myeloid, Acute / surgery
  • Leukemia, Myeloid, Acute / therapy*
  • Living Donors
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / pathology
  • Retrospective Studies
  • Survivors
  • Transplantation Conditioning / methods*
  • Transplantation, Homologous
  • Whole-Body Irradiation
  • Young Adult

Substances

  • Cyclophosphamide