Universität zu Köln

Stelljes, Matthias, Krug, Utz, Beelen, Dietrich W., Braess, Jan, Sauerland, Maria C., Heinecke, Achim, Ligges, Sandra, Sauer, Tim, Tschanter, Petra, Thoennissen, Gabriela B., Berning, Bjoerna, Kolb, Hans J., Reichle, Albrecht, Holler, Ernst, Schwerdtfeger, Rainer, Arnold, Renate, Scheid, Christoph, Mueller-Tidow, Carsten, Woermann, Bernhard J., Hiddemann, Wolfgang, Berdel, Wolfgang E. and Buechner, Thomas (2014). Allogeneic Transplantation Versus Chemotherapy as Postremission Therapy for Acute Myeloid Leukemia: A Prospective Matched Pairs Analysis. J. Clin. Oncol., 32 (4). S. 288 - 302. ALEXANDRIA: AMER SOC CLINICAL ONCOLOGY. ISSN 1527-7755

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Abstract

Purpose The majority of patients with acute myeloid leukemia (AML) who achieve complete remission (CR) relapse with conventional postremission chemotherapy. Allogeneic stem-cell transplantation (alloSCT) might improve survival at the expense of increased toxicity. It remains unknown for which patients alloSCT is preferable. Patients and Methods We compared the outcome of 185 matched pairs of a large multicenter clinical trial (AMLCG99). Patients younger than 60 years who underwent alloSCT in first remission (CR1) were matched to patients who received conventional postremission therapy. The main matching criteria were AML type, cytogenetic risk group, patient age, and time in first CR. Results In the overall pairwise compared AML population, the projected 7-year overall survival (OS) rate was 58% for the alloSCT and 46% for the conventional postremission treatment group (P = .037; log-rank test). Relapse-free survival (RFS) was 52% in the alloSCT group compared with 33% in the control group (P < .001). OS was significantly better for alloSCT in patient subgroups with nonfavorable chromosomal aberrations, patients older than 45 years, and patients with secondary AML or high-risk myelodysplastic syndrome. For the entire patient cohort, postremission therapy was an independent factor for OS (hazard ratio, 0.66; 95% CI, 0.49 to 0.89 for alloSCT v conventional chemotherapy), among age, cytogenetics, and bone marrow blasts after the first induction cycle. Conclusion AlloSCT is the most potent postremission therapy for AML and is particularly active for patients 45 to 59 years of age and/or those with high-risk cytogenetics.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Stelljes, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Krug, Utz UNSPECIFIED UNSPECIFIED UNSPECIFIED Beelen, Dietrich W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Braess, Jan UNSPECIFIED UNSPECIFIED UNSPECIFIED Sauerland, Maria C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Heinecke, Achim UNSPECIFIED UNSPECIFIED UNSPECIFIED Ligges, Sandra UNSPECIFIED UNSPECIFIED UNSPECIFIED Sauer, Tim UNSPECIFIED UNSPECIFIED UNSPECIFIED Tschanter, Petra UNSPECIFIED UNSPECIFIED UNSPECIFIED Thoennissen, Gabriela B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Berning, Bjoerna UNSPECIFIED UNSPECIFIED UNSPECIFIED Kolb, Hans J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Reichle, Albrecht UNSPECIFIED UNSPECIFIED UNSPECIFIED Holler, Ernst UNSPECIFIED UNSPECIFIED UNSPECIFIED Schwerdtfeger, Rainer UNSPECIFIED UNSPECIFIED UNSPECIFIED Arnold, Renate UNSPECIFIED UNSPECIFIED UNSPECIFIED Scheid, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller-Tidow, Carsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Woermann, Bernhard J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hiddemann, Wolfgang UNSPECIFIED UNSPECIFIED UNSPECIFIED Berdel, Wolfgang E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Buechner, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-447644
DOI:	10.1200/JCO.2013.50.5768
Journal or Publication Title:	J. Clin. Oncol.
Volume:	32
Number:	4
Page Range:	S. 288 - 302
Date:	2014
Publisher:	AMER SOC CLINICAL ONCOLOGY
Place of Publication:	ALEXANDRIA
ISSN:	1527-7755
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language STEM-CELL TRANSPLANTATION; ACUTE MYELOGENOUS LEUKEMIA; 1ST COMPLETE REMISSION; HIGH-DOSE CYTARABINE; PROLONGED MAINTENANCE; FAVORABLE PROGNOSIS; YOUNGER ADULTS; GENE-MUTATIONS; AML; INDUCTION Multiple languages Oncology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/44764