title: Impact of cytogenetics on outcome of matched unrelated donor hematopoietic stem cell transplantation for acute myeloid leukemia in first or second complete remission.
abstract: We compared the treatment-related mortality, relapse rate, disease-free survival (DFS), and overall survival (OS) by cytogenetic risk group of 261 patients with acute myeloid leukemia in first complete remission (CR1) and 299 patients in CR2 in undergoing matched unrelated donor hematopoietic stem cell transplantation (HSCT). For patients in first CR, the DFS and OS at 5 years were similar for the favorable, intermediate, and unfavorable risk groups at 29% (95% confidence interval [CI], 8%-56%) and 30% (22%-38%); 27% (19%-39%) and 29% (8%-56%); and 30% (95% CI, 22%-38%) and 30% (95% CI, 20%-41%), respectively. For patients in second CR, the DFS and OS at 5 years were 42% (95% CI, 33%-52%) and 35% (95% CI, 28%-43%); 38% (95% CI, 23%-54%) and 45% (95% CI, 35%-55%); and 37% (95% CI, 30%-45%) and 36% (95% CI, 21%-53%), respectively. Cytogenetics had little influence on the overall outcome for patients in first CR. In second CR, outcome was modestly, but not significantly, better for patients with favorable cytogenetics. The graft-versus-leukemia effect appeared effective, even in patients with unfavorable cytogenetics. However, treatment-related mortality was high. Matched unrelated donor HSCT should be considered for all patients with unfavorable cytogenetics who lack a suitable HLA-matched sibling donor.
authors: Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA. m-tallman@northwestern.edu
authors: Martin S
authors: MS
authors: Tallman
authors: Gordon W
authors: GW
authors: Dewald
authors: Sharavi
authors: S
authors: Gandham
authors: Brent R
authors: BR
authors: Logan
authors: Armand
authors: A
authors: Keating
authors: Hillard M
authors: HM
authors: Lazarus
authors: Mark R
authors: MR
authors: Litzow
authors: Jayesh
authors: J
authors: Mehta
authors: Tanya
authors: T
authors: Pedersen
authors: Waleska S
authors: WS
authors: Pérez
authors: Jacob M
authors: JM
authors: Rowe
authors: Meir
authors: M
authors: Wetzler
authors: Daniel J
authors: DJ
authors: Weisdorf
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D002869:Chromosome Aberrations; D003582:Cytogenetics; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods / Q000401:mortality*; D006648:Histocompatibility; D006801:Humans; D007951:Leukemia, Myeloid / Q000235:genetics* / Q000401:mortality / Q000628:therapy*; D008875:Middle Aged; D012074:Remission Induction; D016019:Survival Analysis; D014019:Tissue Donors; D016896:Treatment Outcome