title: Effect of post-remission chemotherapy preceding allogeneic hematopoietic cell transplant in patients with acute myeloid leukemia in first remission.
abstract: Patients with acute myeloid leukemia (AML) with intermediate or high risk cytogenetics are often considered for allogeneic hematopoietic stem cell transplant (AHSCT) in first remission. Between attainment of remission and AHSCT, post-remission chemotherapy is frequently administered, though there is no evidence for its effectiveness. This study was performed to determine the impact of post-remission chemotherapy on outcome after AHSCT. A subset analysis was performed to determine whether the influence of post-remission chemotherapy might be different in those with intermediate compared to high risk cytogenetics. There was no significant difference in relapse mortality (RM) (p = 0.70), non-relapse mortality (NRM) (p = 0.12), or survival (OS) (p = 0.15) between post-remission chemotherapy groups. There was no difference in RM, NRM, or OS between cytogenetic groups according to whether they received post-remission chemotherapy. No differential effect between intermediate and high risk cytogenetics was detected (RM, p = 0.80; NRM, p = 0.23; OS, p = 0.26). These data do not show a benefit of post-remission chemotherapy before AHSCT.
authors.affiliation: Banner Blood and Marrow Transplant Program, Phoenix, Arizona 85006, USA. lisa.sproat@bannerhealth.com
authors.forename: Lisa
authors.initials: L
authors.lastname: Sproat
authors.forename: Brian
authors.initials: B
authors.lastname: Bolwell
authors.forename: Lisa
authors.initials: L
authors.lastname: Rybicki
authors.forename: Shawnda
authors.initials: S
authors.lastname: Tench
authors.forename: Josephine
authors.initials: J
authors.lastname: Chan
authors.forename: Matt
authors.initials: M
authors.lastname: Kalaycio
authors.forename: Robert
authors.initials: R
authors.lastname: Dean
authors.forename: Ronald
authors.initials: R
authors.lastname: Sobecks
authors.forename: Brad
authors.initials: B
authors.lastname: Pohlman
authors.forename: Steven
authors.initials: S
authors.lastname: Andresen
authors.forename: John
authors.initials: J
authors.lastname: Sweetenham
authors.forename: Edward
authors.initials: E
authors.lastname: Copelan
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D015331:Cohort Studies; D003561:Cytarabine / Q000008:administration & dosage; D020732:Cytogenetic Analysis; D003630:Daunorubicin / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000209:etiology / Q000401:mortality / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015255:Idarubicin / Q000008:administration & dosage; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality; D018365:Neoplasm, Residual / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality; D012074:Remission Induction; D012189:Retrospective Studies; D015996:Survival Rate; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D003561:Cytarabine; D015255:Idarubicin; D003630:Daunorubicin