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1000 Titel
  • Allogeneic hematopoietic stem cell transplantation improves long-term outcome for relapsed AML patients across all ages: results from two East German Study Group Hematology and Oncology (OSHO) trials
1000 Autor/in
  1. Heinicke, Thomas |
  2. Krahl, Rainer |
  3. Kahl, Christoph |
  4. Cross, Michael |
  5. Scholl, Sebastian |
  6. Wolf, Hans-Heinrich |
  7. Hähling, Detlev |
  8. Hegenbart, Ute |
  9. Peter, Norma |
  10. Schulze, Antje |
  11. Florschütz, Axel |
  12. Schmidt, Volker |
  13. Reifenrath, Kolja |
  14. Zojer, Niklas |
  15. Junghanss, Christian |
  16. Sayer, Herbert G. |
  17. Maschmeyer, Georg |
  18. Späth, Christian |
  19. Hochhaus, Andreas |
  20. Fischer, Thomas |
  21. Al-Ali, Haifa Kathrin |
  22. Niederwieser, Dietger |
1000 Erscheinungsjahr 2021
1000 Publikationstyp
  1. Artikel |
1000 Online veröffentlicht
  • 2021-07-07
1000 Erschienen in
1000 Quellenangabe
  • 100(9):2387-2398
1000 Copyrightjahr
  • 2021
1000 Lizenz
1000 Verlagsversion
  • https://doi.org/10.1007/s00277-021-04565-1 |
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8357692/ |
1000 Publikationsstatus
1000 Sprache der Publikation
1000 Abstract/Summary
  • Relapse of acute leukemia is a frequent complication with uncertain outcome and poorly defined risk factors. From 1621 patients entered into two prospective clinical trials (AML02; n = 740 and AML04; n = 881), 74.2% reached complete remission (CR) 1 after induction(s) and 59 patients after additional induction ± hematopoietic cell transplantation (HCT). Of the non-refractory patients, 48.4% with a median age of 63 (range 17-85) years relapsed. Relapses occurred within 6 months after CR in 46.5%, between 7 and 18 months in 38.7%, and after 18 months in 14.8% of patients. Relapse treatment resulted in CR2 in 39% of patients depending upon age (54.5% of ≤ 60 and 28.6% of > 60 years), duration of CR1, and treatment of relapse. Overall survival (OS) was 10.9 (7.4-16.2) %, but OS after HCT ± intensive chemotherapy (ICT) was 39.3% (31.8-48.6) at 5 years and not different in younger and older patients. Donor lymphocyte infusion ± chemotherapy and ICT alone resulted only in OS of 15.4% and of 5%, respectively. Independent favorable factors for OS were long CR1 duration, and HCT, while non-monosomal disease was beneficial for OS in elderly patients. Leukemia-free survival [LFS; 24.9 (19.5-31.7) % at 10 years] was affected by similar risk factors. In a competing risk model, the relapse incidence at 5 years was 53.5 ± 3.5% and the non-relapse mortality rate 21.7 ± 2.9%. Lower relapse incidence was observed in patents with HCT, long CR1 duration, and female gender. Risk factors for non-relapse mortality were HCT in younger and type of AML in elderly patients. In conclusion, allogeneic HCT ± IC improved the results in relapsed AML in younger and elderly patients. Increasing CR2 rates and HCT frequency will be the challenge for the next years. Relapse of the disease remains the major problem.
1000 Sacherschließung
lokal Adolescent [MeSH]
lokal Female [MeSH]
lokal Aged, 80 and over [MeSH]
lokal Aged [MeSH]
lokal Adult [MeSH]
lokal Humans [MeSH]
lokal Prospective Studies [MeSH]
lokal Relapsed acute myeloid leukemia
lokal Treatment Outcome [MeSH]
lokal Hematopoietic Stem Cell Transplantation [MeSH]
lokal Middle Aged [MeSH]
lokal Prognostic factors
lokal Allogeneic stem cell transplantation
lokal Germany/epidemiology [MeSH]
lokal Original Article
lokal Male [MeSH]
lokal Leukemia, Myeloid, Acute/epidemiology [MeSH]
lokal Young Adult [MeSH]
lokal Leukemia, Myeloid, Acute/therapy [MeSH]
lokal Neoplasm Recurrence, Local/therapy [MeSH]
lokal Transplantation, Homologous [MeSH]
1000 Liste der Beteiligten
  1. https://frl.publisso.de/adhoc/uri/SGVpbmlja2UsIFRob21hcw==|https://frl.publisso.de/adhoc/uri/S3JhaGwsIFJhaW5lcg==|https://frl.publisso.de/adhoc/uri/S2FobCwgQ2hyaXN0b3Bo|https://frl.publisso.de/adhoc/uri/Q3Jvc3MsIE1pY2hhZWw=|https://frl.publisso.de/adhoc/uri/U2Nob2xsLCBTZWJhc3RpYW4=|https://frl.publisso.de/adhoc/uri/V29sZiwgSGFucy1IZWlucmljaA==|https://frl.publisso.de/adhoc/uri/SMOkaGxpbmcsIERldGxldg==|https://frl.publisso.de/adhoc/uri/SGVnZW5iYXJ0LCBVdGU=|https://frl.publisso.de/adhoc/uri/UGV0ZXIsIE5vcm1h|https://frl.publisso.de/adhoc/uri/U2NodWx6ZSwgQW50amU=|https://frl.publisso.de/adhoc/uri/RmxvcnNjaMO8dHosIEF4ZWw=|https://frl.publisso.de/adhoc/uri/U2NobWlkdCwgVm9sa2Vy|https://frl.publisso.de/adhoc/uri/UmVpZmVucmF0aCwgS29samE=|https://frl.publisso.de/adhoc/uri/Wm9qZXIsIE5pa2xhcw==|https://frl.publisso.de/adhoc/uri/SnVuZ2hhbnNzLCBDaHJpc3RpYW4=|https://frl.publisso.de/adhoc/uri/U2F5ZXIsIEhlcmJlcnQgRy4=|https://frl.publisso.de/adhoc/uri/TWFzY2htZXllciwgR2Vvcmc=|https://frl.publisso.de/adhoc/uri/U3DDpHRoLCBDaHJpc3RpYW4=|https://frl.publisso.de/adhoc/uri/SG9jaGhhdXMsIEFuZHJlYXM=|https://frl.publisso.de/adhoc/uri/RmlzY2hlciwgVGhvbWFz|https://frl.publisso.de/adhoc/uri/QWwtQWxpLCBIYWlmYSBLYXRocmlu|https://orcid.org/0000-0002-4737-1103
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