Reference : Similar outcome of allogeneic stem cell transplantation after myeloablative and seque...
Scientific journals : Article
Human health sciences : Hematology
http://hdl.handle.net/2268/227640
Similar outcome of allogeneic stem cell transplantation after myeloablative and sequential conditioning regimen in patients with refractory or relapsed acute myeloid leukemia: A study from the Societe Francophone de Greffe de Moelle et de Therapie Cellulaire.
English
Decroocq, Justine [> >]
Itzykson, Raphael [> >]
Vigouroux, Stephane [> >]
Michallet, Mauricette [> >]
Yakoub-Agha, Ibrahim [> >]
Huynh, Anne [> >]
Beckerich, Florence [> >]
Suarez, Felipe [> >]
Chevallier, Patrice [> >]
Nguyen-Quoc, Stephanie [> >]
Ledoux, Marie-Pierre [> >]
Clement, Laurence [> >]
Hicheri, Yosr [> >]
Guillerm, Gaelle [> >]
Cornillon, Jerome [> >]
Contentin, Nathalie [> >]
Carre, Martin [> >]
Maillard, Natacha [> >]
Mercier, Melanie [> >]
Mohty, Mohamad [> >]
Beguin, Yves mailto [Université de Liège - ULiège > > GIGA-R : Hématologie >]
Bourhis, Jean-Henri [> >]
Charbonnier, Amandine [> >]
Dauriac, Charles [> >]
Bay, Jacques-Olivier [> >]
Blaise, Didier [> >]
Deconinck, Eric [> >]
Jubert, Charlotte [> >]
Raus, Nicole [> >]
Peffault de Latour, Regis [> >]
Dhedin, Nathalie [> >]
2018
American journal of hematology
93
3
416-423
Yes (verified by ORBi)
International
0361-8609
1096-8652
United States
[en] Patients with acute myeloid leukemia (AML) in relapse or refractory to induction therapy have a dismal prognosis. Allogeneic hematopoietic stem cell transplantation is the only curative option. In these patients, we aimed to compare the results of a myeloablative transplant versus a sequential approach consisting in a cytoreductive chemotherapy followed by a reduced intensity conditioning regimen and prophylactic donor lymphocytes infusions. We retrospectively analyzed 99 patients aged 18-50 years, transplanted for a refractory (52%) or a relapsed AML not in remission (48%). Fifty-eight patients received a sequential approach and 41 patients a myeloablative conditioning regimen. Only 6 patients received prophylactic donor lymphocytes infusions. With a median follow-up of 48 months, 2-year overall survival was 39%, 95% confidence interval (CI) (24-53) in the myeloablative group versus 33%, 95% CI (21-45) in the sequential groups (P = .39), and 2-year cumulative incidence of relapse (CIR) was 57% versus 50% respectively (P = .99). Nonrelapse mortality was not higher in the myeloablative group (17% versus 15%, P = .44). In multivariate analysis, overall survival, CIR and nonrelapse mortality remained similar between the two groups. However, in multivariate analysis, sequential conditioning led to fewer acute grade II-IV graft versus host disease (GVHD) (HR for sequential approach = 0.37; 95% CI: 0.21-0.65; P < .001) without a significant impact on chronic GVHD (all grades and extensive). In young patients with refractory or relapsed AML, myeloablative transplant and sequential approach offer similar outcomes except for a lower incidence of acute GvHD after a sequential transplant.
http://hdl.handle.net/2268/227640
10.1002/ajh.25004
(c) 2018 Wiley Periodicals, Inc.

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