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Early blast clearance during sequential conditioning prior to allogeneic stem cell transplantation in patients with acute myeloid leukaemia.
Ronnacker, Julian; Urbahn, Marc-Andre; Reicherts, Christian; Kolloch, Lina; Berning, Philipp; Sandmann, Sarah; Eßeling, Eva; Call, Simon; Floeth, Matthias; Marx, Julia; Albring, Jörn; Mikesch, Jan-Henrik; Schliemann, Christoph; Lenz, Georg; Stelljes, Matthias.
Afiliación
  • Ronnacker J; Department of Medicine A, Haematology and Oncology, University Hospital Muenster, Muenster, Germany.
  • Urbahn MA; Department of Medicine A, Haematology and Oncology, University Hospital Muenster, Muenster, Germany.
  • Reicherts C; Department of Medicine A, Haematology and Oncology, University Hospital Muenster, Muenster, Germany.
  • Kolloch L; Department of Medicine A, Haematology and Oncology, University Hospital Muenster, Muenster, Germany.
  • Berning P; Department of Medicine A, Haematology and Oncology, University Hospital Muenster, Muenster, Germany.
  • Sandmann S; Institute of Medical Informatics, University of Muenster, Muenster, Germany.
  • Eßeling E; Department of Medicine A, Haematology and Oncology, University Hospital Muenster, Muenster, Germany.
  • Call S; Department of Medicine A, Haematology and Oncology, University Hospital Muenster, Muenster, Germany.
  • Floeth M; Department of Medicine A, Haematology and Oncology, University Hospital Muenster, Muenster, Germany.
  • Marx J; Department of Medicine A, Haematology and Oncology, University Hospital Muenster, Muenster, Germany.
  • Albring J; Department of Medicine A, Haematology and Oncology, University Hospital Muenster, Muenster, Germany.
  • Mikesch JH; Department of Medicine A, Haematology and Oncology, University Hospital Muenster, Muenster, Germany.
  • Schliemann C; Department of Medicine A, Haematology and Oncology, University Hospital Muenster, Muenster, Germany.
  • Lenz G; Department of Medicine A, Haematology and Oncology, University Hospital Muenster, Muenster, Germany.
  • Stelljes M; Department of Medicine A, Haematology and Oncology, University Hospital Muenster, Muenster, Germany.
Br J Haematol ; 205(1): 280-290, 2024 Jul.
Article en En | MEDLINE | ID: mdl-38831752
ABSTRACT
For patients with relapsed or refractory AML, sequential conditioning prior to allogeneic stem cell transplantation (alloSCT) is an established and potentially curative treatment option. Early response to treatment during conditioning indicates chemotherapy-responsive disease and may have prognostic value. We retrospectively evaluated blast clearance on day 5 after melphalan, administered 11 days prior to alloSCT as part of a sequential conditioning in 176 patients with active AML. Overall survival (OS) was 52% (95% confidence interval [CI] 45%-60%), and relapse-free survival (RFS) was 47% (95% CI 40%-55%) at 3 years. Patients who achieved early blast clearance did not show a significant improvement in OS and RFS (OS, hazard ratio [HR] HR 0.75, p 0.19; RFS, HR 0.71, p 0.09, respectively), but had a significantly lower non-relapse mortality rate (HR 0.46, p 0.017). HLA-mismatched donor, older age, adverse genetic risk and higher comorbidity scores were associated with inferior survival outcomes. A high initial blast count was only associated with inferior prognosis in patients receiving chemotherapy-only compared to total body irradiation containing conditioning therapy. These results indicate that for patients transplanted with active AML, sensitivity to chemotherapy might be of less importance, compared to other disease- and transplant-related factors.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trasplante Homólogo / Leucemia Mieloide Aguda / Trasplante de Células Madre Hematopoyéticas / Acondicionamiento Pretrasplante Límite: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Br J Haematol Año: 2024 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trasplante Homólogo / Leucemia Mieloide Aguda / Trasplante de Células Madre Hematopoyéticas / Acondicionamiento Pretrasplante Límite: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Br J Haematol Año: 2024 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Reino Unido