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Trends in outcome of transplantation in patients with secondary acute myeloid leukemia: an analysis from the Acute Leukemia Working Party (ALWP) of the EBMT.
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Edité par CCSD ; Nature Publishing Group -
International audience. Trends in outcome of transplantation (HSCT) in secondary acute myeloid leukemia (sAML) are limited. We evaluated results of HSCT in 4224 patients with sAML in complete remission; 1337 were transplanted in 2000–2010 and 2887 in 2011–2020. Median age was 54 (range, 18–74) and 59 (range, 18–78) years, respectively (p < 0.0001). Donors were MSD in 65% vs. 37%, 10/10 UD in 27% vs. 50%, and 9/10 UD in 8% vs. 13%, respectively (p < 0.0001). Conditioning was myeloablative in 46% and 38%, respectively. Two-year non-relapse mortality (NRM) was lower in patients transplanted in 2011–2020 vs. those transplanted in 2000–2010, 18% vs. 21% (hazard ratio (HR) = 0.82, 95% CI: 0.68–0.9; p = 0.04) and modified GVHD-free, relapse-free survival (GRFS) (HR = 0.9, 95% CI: 0.81–0.99; p = 0.04) was better in patients transplanted in the 2011–2020 vs. those transplanted in 2000–2010. Two-year relapse incidence (RI) was similar between the 2 groups with 32% vs. 31%, (HR = 1.05, 95% CI: 0.9–1.22; p = 0.55). Likewise, leukemia-free survival (LFS) (HR = 0.95, 95% CI: 0.84–1.07; p = 0.38) and overall survival (OS) (HR = 0.93, 95% CI: 0.82–1.05; p = 0.26) were not significantly different between the two periods. In conclusion, Incidence of NRM has been significantly reduced and GRFS significantly increased in HSCT for sAML in the last 2 decades.
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