Graft-versus-host disease and graft-versus-leukaemia effects in secondary acute myeloid leukaemia: a retrospective, multicentre registry analysis from the Acute Leukaemia Working Party of the EBMT

Baron, Frédéric; Labopin, M.; Savani, B. N.; Beohou, E.; Niederwieser, D.; Eder, M.; Potter, V.; Kröger, N.; Beelen, D.; Socié, G.; Itälä-Remes, M.; Bornhäuser, M.; Mohty, M.; Nagler, A.

doi:10.1111/bjh.16185

Article (Scientific journals)

Graft-versus-host disease and graft-versus-leukaemia effects in secondary acute myeloid leukaemia: a retrospective, multicentre registry analysis from the Acute Leukaemia Working Party of the EBMT

Baron, Frédéric; Labopin, M.; Savani, B. N. et al.

2020 • In British Journal of Haematology, 188, p. 428-437

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https://hdl.handle.net/2268/243668

DOI
10.1111/bjh.16185

PubMed
31612473

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Keywords :

GVHD

Abstract :

[en] We assessed the susceptibility of secondary acute myeloid leukaemia (sAML) to graft-versus-leukaemia effects. Data from 2414 sAML patients in first (n = 2194) or second (n = 220) complete remission were included. They were given grafts from human leucocyte antigen (HLA)-matched sibling (MSD, n = 1085), 10/10 unrelated donor (MUD, n = 1066) or 9/10 mismatched unrelated donor (MMUD, n = 263). The 100-day incidence of grade II-IV acute graft-versus-host disease (GVHD) was 25% while 2-year incidence of chronic GVHD was 38%. Relapse rates declined steadily by duration of follow-up and were significantly lower in patients with chronic GVHD (P < 0·001). Limited (hazard ratio [HR] = 0·66, P < 0·001) and extensive (HR = 0·52, P < 0·001) chronic GVHD were associated with a lower incidence of relapse. Each grade III-IV acute (HR = 7·04, P < 0·001) as well as limited (HR = 1·42, P = 0·03) and extensive (HR = 3·97, P < 0·001) chronic GVHD were associated with higher non-relapse mortality (NRM). This translated to better overall survival (OS; HR = 0·61, P < 0·001) in patients with limited chronic GVHD. In contrast, grade III-IV acute and extensive chronic GVHD were associated with worse OS (HR = 3·16, P < 0·001 and HR = 1·21, P = 0·03, respectively). Further, in comparison to HLA-identical sibling recipients, MUD recipients had a lower risk of relapse (HR = 0·82, P = 0·03) but higher NRM (HR = 1·38, P = 0·004). In conclusion, these data demonstrate that sAML is susceptible to graft-versus-leukaemia effects. © 2019 British Society for Haematology and John Wiley & Sons Ltd

Disciplines :

Hematology

Author, co-author :

Baron, Frédéric ; Université de Liège - ULiège > I3-Hematology

Labopin, M.; EBMT Paris Office, Hospital Saint Antoine, Paris, France, AP-HP, Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, Paris, France, Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, Université Pierre & Marie Curie and INSERM UMRs U938, Paris, France

Savani, B. N.; Vanderbilt University Medical Center, Nashville, TN, United States

Beohou, E.; EBMT Paris Office, Hospital Saint Antoine, Paris, France

Niederwieser, D.; Division of Haematology & Oncology, University Hospital Leipzig, Leipzig, Germany

Eder, M.; Department of Haematology, Haemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany

Potter, V.; Department of Haematological Medicine, GKT School of Medicine, London, United Kingdom

Kröger, N.; Bone Marrow Transplantation Centre, University Hospital Eppendorf, Hamburg, Germany

Beelen, D.; Department of Bone Marrow Transplantation, West German Cancer Center, University Hospital of Essen, Essen, Germany

Socié, G.; Department of Haematology – BMT, Hopital St. Louis, Paris, France

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Language :

English

Title :

Graft-versus-host disease and graft-versus-leukaemia effects in secondary acute myeloid leukaemia: a retrospective, multicentre registry analysis from the Acute Leukaemia Working Party of the EBMT

Publication date :

2020

Journal title :

British Journal of Haematology

ISSN :

0007-1048

eISSN :

1365-2141

Publisher :

Blackwell Publishing Ltd

Volume :

188

Pages :

428-437

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 21 January 2020

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