PURPOSE: Patients with acute myelocytic leukemia carrying inversion 16 (inv16) or t(8;21) have a better initial response to high-dose cytarabine than patients without these chromosomal abnormalities. They presently do not undergo transplantation in first remission (CR1), but there is concern about late relapses. PATIENTS AND METHODS: From 1990 to 2004, 325 adult patients received transplantations in CR1 (159 patients with inv16 and 166 patients with t(8;21), including 35 and 60 patients, respectively, with additional chromosomal abnormalities). Genoidentical allografts were performed in 64 patients with inv16 and 81 patients with t(8;21), and autografts were performed in 95 patients with inv16 and 85 patients with t(8;21). RESULTS: In patients with inv16, after allogeneic and autologous transplantation, the 5-year leukemia-free survival (LFS) rates were 59% and 66% (P = .5), the relapse incidence (RI) rates were 27% and 32% (P = .45), and the transplantation-related mortality (TRM) rates were 14% and 2% (P = .003), respectively. Female patients had a lower RI and a higher LFS. Additional chromosomal abnormalities, compared with no additional abnormalities, were associated with lower RI rate (12% v 34%, respectively; P = .01) and higher 5-year LFS rate (78% v 59%, respectively; P = .04). In patients with t(8;21), after allogeneic and autologous transplantation, the 5-year LFS rates were 60% and 66% (P = .69), the RI rates were 15% and 28% (P = .03), and the TRM rates were 24% and 6% (P = .003), respectively. Younger age and a lower WBC count at diagnosis were associated with a lower TRM and a better LFS. The TRM was lower and the RI was higher in patients with autologous transplantations versus allogeneic transplantations. CONCLUSION: Both autologous and allogeneic transplantation resulted in similar outcomes.

Identical outcome after autologous or allogeneic genoidentical hematopoietic stem-cell transplantation in first remission of acute myelocytic leukemia carrying inversion 16 or t(8;21): A retrospective study from the European Cooperative Group for Blood and Marrow Transplantation / N. C., Gorin; M., Labopin; F., Frassoni; N., Milpied; M., Attal; D., Blaise; Meloni, Giovanna; A. P., Iori; M., Michallet; R., Willemze; E., Deconninck; J. L., Harousseau; E., Polge; V., Rocha. - In: JOURNAL OF CLINICAL ONCOLOGY. - ISSN 0732-183X. - 26:19(2008), pp. 3183-3188. [10.1200/jco.2007.15.3106]

Identical outcome after autologous or allogeneic genoidentical hematopoietic stem-cell transplantation in first remission of acute myelocytic leukemia carrying inversion 16 or t(8;21): A retrospective study from the European Cooperative Group for Blood and Marrow Transplantation

MELONI, Giovanna;
2008

Abstract

PURPOSE: Patients with acute myelocytic leukemia carrying inversion 16 (inv16) or t(8;21) have a better initial response to high-dose cytarabine than patients without these chromosomal abnormalities. They presently do not undergo transplantation in first remission (CR1), but there is concern about late relapses. PATIENTS AND METHODS: From 1990 to 2004, 325 adult patients received transplantations in CR1 (159 patients with inv16 and 166 patients with t(8;21), including 35 and 60 patients, respectively, with additional chromosomal abnormalities). Genoidentical allografts were performed in 64 patients with inv16 and 81 patients with t(8;21), and autografts were performed in 95 patients with inv16 and 85 patients with t(8;21). RESULTS: In patients with inv16, after allogeneic and autologous transplantation, the 5-year leukemia-free survival (LFS) rates were 59% and 66% (P = .5), the relapse incidence (RI) rates were 27% and 32% (P = .45), and the transplantation-related mortality (TRM) rates were 14% and 2% (P = .003), respectively. Female patients had a lower RI and a higher LFS. Additional chromosomal abnormalities, compared with no additional abnormalities, were associated with lower RI rate (12% v 34%, respectively; P = .01) and higher 5-year LFS rate (78% v 59%, respectively; P = .04). In patients with t(8;21), after allogeneic and autologous transplantation, the 5-year LFS rates were 60% and 66% (P = .69), the RI rates were 15% and 28% (P = .03), and the TRM rates were 24% and 6% (P = .003), respectively. Younger age and a lower WBC count at diagnosis were associated with a lower TRM and a better LFS. The TRM was lower and the RI was higher in patients with autologous transplantations versus allogeneic transplantations. CONCLUSION: Both autologous and allogeneic transplantation resulted in similar outcomes.
2008
01 Pubblicazione su rivista::01a Articolo in rivista
Identical outcome after autologous or allogeneic genoidentical hematopoietic stem-cell transplantation in first remission of acute myelocytic leukemia carrying inversion 16 or t(8;21): A retrospective study from the European Cooperative Group for Blood and Marrow Transplantation / N. C., Gorin; M., Labopin; F., Frassoni; N., Milpied; M., Attal; D., Blaise; Meloni, Giovanna; A. P., Iori; M., Michallet; R., Willemze; E., Deconninck; J. L., Harousseau; E., Polge; V., Rocha. - In: JOURNAL OF CLINICAL ONCOLOGY. - ISSN 0732-183X. - 26:19(2008), pp. 3183-3188. [10.1200/jco.2007.15.3106]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/89410
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