title: Unrelated donor transplantation for acute myelogenous leukemia in first remission.
abstract: We retrospectively analyzed the outcomes of all acute myelogenous leukemia (AML) patients in first remission (n = 44; median age = 48 years; high-risk cytogenetics = 59%) who received unrelated donor hematopoietic cell transplantation (HCT) with myeloablative conditioning regimen of i.v. busulfan, fludarabine, and antithymocyte globulin (ATG) between January 2002 and November 2009 at our institution. Donor-recipient pairs were matched by high-resolution HLA-A, -B, -C, -DRB1, and -DQB1 typing (10/10 matches, n = 41; 9/10 matches, n = 3). With a median follow-up of 34 months, actuarial 3-year event-free survival (EFS) and overall survival (OS) is 70% and 78%, respectively. The 3-year EFS and OS in patients with and without poor risk cytogenetics is similar (63% versus 82%, P = 0.43 and 78% versus 82%, P = .89, respectively). The 3-year EFS and OS is also similar in patients above age 55 year versus patients age 55 year or younger (80% versus 67%, P = .47 and 80% versus 78%, P = .81, respectively). The 100-day and 3-year cumulative incidence of transplant-related mortality is 5% and 15%, respectively. Six patients have relapsed, and 3 of them are alive and in remission after salvage therapy, with a median follow-up of 23 months. These results indicate that the majority of AML patients eligible for this treatment can achieve long-term disease control.
authors.affiliation: Department of Stem Cell Transplantation and Cellular Therapy, U.T. M.D. Anderson Cancer Center, Houston, Texas 77030-4009, USA. qbashir@mdanderson.org
authors.forename: Qaiser
authors.initials: Q
authors.lastname: Bashir
authors.forename: Borje S
authors.initials: BS
authors.lastname: Andersson
authors.forename: Marcelo
authors.initials: M
authors.lastname: Fernandez-Vina
authors.forename: Leandro
authors.initials: L
authors.lastname: de Padua Silva
authors.forename: Sergio
authors.initials: S
authors.lastname: Giralt
authors.forename: Alexandre
authors.initials: A
authors.lastname: Chiattone
authors.forename: Wei
authors.initials: W
authors.lastname: Wei
authors.forename: Manish
authors.initials: M
authors.lastname: Sharma
authors.forename: Paolo
authors.initials: P
authors.lastname: Anderlini
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Shpall
authors.forename: Uday
authors.initials: U
authors.lastname: Popat
authors.forename: Morgani
authors.initials: M
authors.lastname: Rodrigues
authors.forename: Richard E
authors.initials: RE
authors.lastname: Champlin
authors.forename: Marcos
authors.initials: M
authors.lastname: de Lima
mesh_terms: D000293:Adolescent; D000328:Adult; D000961:Antilymphocyte Serum / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016026:Bone Marrow Transplantation / Q000379:methods* / Q000706:statistics & numerical data; D002066:Busulfan / Q000008:administration & dosage; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D053208:Kaplan-Meier Estimate; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy / Q000235:genetics / Q000601:surgery*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D019653:Myeloablative Agonists / Q000627:therapeutic use; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods* / Q000706:statistics & numerical data; D012074:Remission Induction; D012189:Retrospective Studies; D016879:Salvage Therapy; D013601:T-Lymphocytes; D019172:Transplantation Conditioning / Q000379:methods; D014184:Transplantation, Homologous / Q000706:statistics & numerical data*; D014740:Vidarabine / Q000008:administration & dosage / Q000031:analogs & derivatives; D055815:Young Adult
chemical_list: D000961:Antilymphocyte Serum; D019653:Myeloablative Agonists; D014740:Vidarabine; D002066:Busulfan; C024352:fludarabine