In a nutshell
This study aimed to identify the outcomes and prognostic factors following a stem cell transplant from a donor in adults with acute myeloid leukemia in their second complete remission (no sign of disease). The authors determined that this type of transplant was effective in these patients.
Some background
In adult patients with acute myeloid leukemia, it is possible to achieve a first remission (CR1) in 60-85% of patients. However, many of these patients will relapse. In these cases, the only curative option for patients is to receive an allogeneic stem cell transplant, which means the stem cells come from a donor rather than the patient themselves. It is also possible to achieve second complete remission (CR2) through chemotherapy.
Many studies done in the past have included complete remission groups to be a mix of CR1 and CR2 patients. These two groups, however, may differ hugely in disease backgrounds. It is not clear how CR2 patients respond to donor stem cell transplantation.
Methods & findings
This study analyzed information on 1080 AML patients who underwent donor stem cell transplantation.
The probability of three-year overall survival (time from treatment until death from any cause) was 66%. The probability of being disease free and without graft-versus-host disease (when transplanted cells attack healthy tissue) was 62%. The probability of being relapse free was 34%.
Cumulative relapse rate and transplant related mortality (TRM) were both 19%. Disease status at the time of the transplant did not affect TRM.
A shorter period of remission, advanced age and more overall mutations present negatively impacted overall survival.
The bottom line
This study concluded that that a donor stem cell transplant was effective for AML patients in their second remission.
The fine print
This was a retrospective study, meaning that it looked back at information previously collected.
Published By :
British Journal of Haematology
Date :
May 29, 2018
