Hematopoietic stem cell transplantation for de novo erythroleukemia: a study of the European Group for Blood and Marrow Transplantation (EBMT).
De novo erythroleukemia (EL) is a rare disease. Reported median survival are poor and vary from 4 to 14 months. The value of hematopoietic stem cell transplantation (HSCT) for EL is unknown. This EBMT registry study reports on the largest series of patients with EL treated with HSCT in first complete remission-103 autologous and 104 HLA identical sibling allogeneic HSCT. Outcome and identification of prognostic factors for each type of transplantation were evaluated. For autologous HSCT, outcome at 5 years showed a leukemia-free survival (LFS) of 26% +/- 5%, a relapse incidence (RI) of 70% +/- 6%, and a transplant-related mortality (TRM) of 13% +/- 4%. By multivariate analysis, the only prognostic factor was age. For allogeneic HSCT, outcome at 5 years showed an LFS of 57% +/- 5%, an RI of 21% +/- 5%, and a TRM of 27% +/- 5%. By multivariate analysis, prognostic factors were graft-versus-host disease and age. This study represents the largest series of de novo EL treated with HSCT and shows that allogeneic HSCT is by far the most effective treatment.
Fouillard
Loïc
L
Centre International Greffe de Moelle (EBMT), Centre de Recherche Claude Bernard sur la Thérapie Cellulaire, Université Pierre et Marie Curie Paris VI, 75571 Paris Cedex 12, France. fouillar@ext.jussieu.fr
Labopin
Myriam
M
Gorin
Norbert-Claude
NC
Polge
Emmanuelle
E
Prentice
Hugh Grant
HG
Meloni
Giovanna
G
Reiffers
Josy
J
Pigneux
Arnaud
A
Willemze
Roel
R
Schattenberg
Anton
A
Sica
Simona
S
Lagrange
Monique
M
Fenneteau
Odile
O
Perot
Christine
C
Frassoni
Francesco
F
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005060:Europe / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000401:mortality; D006648:Histocompatibility; D006801:Humans; D015994:Incidence; D004915:Leukemia, Erythroblastic, Acute / Q000188:drug therapy / Q000453:epidemiology / Q000628:therapy*; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D012042:Registries; D012074:Remission Induction; D035781:Siblings; D014019:Tissue Donors; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D016896:Treatment Outcome