title: The influence of HLA-matched sibling donor availability on treatment outcome for patients with AML: an analysis of the AML 8A study of the EORTC Leukaemia Cooperative Group and GIMEMA. European Organization for Research and Treatment of Cancer. Gruppo Italiano Malattie Ematologiche Maligne dell'Adulto.
abstract: To determine whether patients with a HLA-identical sibling donor have a better outcome than patients without a donor, an analysis on the basis of intention-to-treat principles was performed within the framework of the EORTC-GIMEMA randomized phase III AML 8A trial. Patients in complete remission (CR) received one intensive consolidation course. Patients with a histocompatible sibling donor were then allocated allogeneic bone marrow transplantation (alloBMT), the patients without a donor were randomized between autologous BMT (ABMT) and a second intensive consolidation (IC2). 831 patients <46 years old and alive >8 weeks from diagnosis were included. HLA typing was performed in 672 patients. AlloBMT was performed during CR1 in 180 (61%) out of 295 patients with a donor. Another 38 patients were allografted: five in resistant disease, 14 during relapse and 19 in CR2. ABMT was performed in 130 (34%) out of 377 patients without a donor in CR1, in six (2%) patients during relapse and in 38 (10%) patients during CR2. The disease-free survival (DFS) from CR for patients with a donor was significantly longer than for patients without a donor (46% v 33% at 6 years; P=0.01, RR 0.78, 95% confidence interval 0.63-0.96). The overall survival from diagnosis for patients with a donor was longer, but not statistically significant, than for patients without a donor (48% v 40% at 6 years; logrank P=0.24). When patients were stratified according to prognostic risk groups, the same trend in favour of patients with a donor was seen for survival duration and the DFS remained significantly longer for this group of patients.
authors.affiliation: EORTC Data Centre, Brussels, Belgium.
authors.forename: S
authors.initials: S
authors.lastname: Keating
authors.forename: T
authors.initials: T
authors.lastname: de Witte
authors.forename: S
authors.initials: S
authors.lastname: Suciu
authors.forename: R
authors.initials: R
authors.lastname: Willemze
authors.forename: M
authors.initials: M
authors.lastname: Hayat
authors.forename: B
authors.initials: B
authors.lastname: Labar
authors.forename: L
authors.initials: L
authors.lastname: Resegotti
authors.forename: P R
authors.initials: PR
authors.lastname: Ferrini
authors.forename: F
authors.initials: F
authors.lastname: Caronia
authors.forename: M
authors.initials: M
authors.lastname: Dardenne
authors.forename: G
authors.initials: G
authors.lastname: Solbu
authors.forename: M C
authors.initials: MC
authors.lastname: Petti
authors.forename: M L
authors.initials: ML
authors.lastname: Vegna
authors.forename: F
authors.initials: F
authors.lastname: Mandelli
authors.forename: R A
authors.initials: RA
authors.lastname: Zittoun
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016026:Bone Marrow Transplantation / Q000379:methods*; D002648:Child; D018572:Disease-Free Survival; D005260:Female; D006650:Histocompatibility Testing; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018570:Risk Assessment; D014019:Tissue Donors / Q000600:supply & distribution*; D019172:Transplantation Conditioning / Q000379:methods; D014182:Transplantation, Autologous; D016896:Treatment Outcome