title: Platelet recovery before allogeneic stem cell transplantation predicts posttransplantation outcomes in patients with acute myelogenous leukemia and myelodysplastic syndrome.
abstract: Complete remission (CR) is the gold standard for assessing outcomes following chemotherapy for acute myelogenous leukemia (AML). "CRp," a response criterion defined as fulfillment of all criteria for CR except platelet count recovery to ≥100 × 10(9)/L, is associated with inferior outcomes following chemotherapy. The prognostic importance of CRp before allogeneic stem cell transplantation (allo-SCT) remains unknown. We analyzed a cohort of AML (n = 334) and myelodysplastic syndrome (MDS; n = 10) patients to determine the prognostic significance of achieving CR versus CRp before allo-SCT. At time of transplantation, 266 patients were in CR (CR1 and ≥CR2) and 78 in CRp (CR1p and ≥CR2p). Median follow-up was 38 months (3-131 months). Overall survival, progression-free survival, and nonrelapse mortality (NRM) were most favorable in patients transplanted in CR (CR1 or ≥CR2) compared with CRp (CR1p or ≥CR2p). Achieving CR is therefore associated with improved posttransplantation outcomes compared with achieving CRp and is a significant prognostic factor that needs to be considered when evaluating AML/MDS patients for clinical trials and allo-SCT.
authors.affiliation: Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030, USA.
authors.forename: Gheath
authors.initials: G
authors.lastname: Alatrash
authors.forename: Matteo
authors.initials: M
authors.lastname: Pelosini
authors.forename: Rima M
authors.initials: RM
authors.lastname: Saliba
authors.forename: Ebru
authors.initials: E
authors.lastname: Koca
authors.forename: Gabriela
authors.initials: G
authors.lastname: Rondon
authors.forename: Borje S
authors.initials: BS
authors.lastname: Andersson
authors.forename: Alexandre
authors.initials: A
authors.lastname: Chiattone
authors.forename: Weiqing
authors.initials: W
authors.lastname: Zhang
authors.forename: Sergio A
authors.initials: SA
authors.lastname: Giralt
authors.forename: Amanda M
authors.initials: AM
authors.lastname: Cernosek
authors.forename: Partow
authors.initials: P
authors.lastname: Kebriaei
authors.forename: Amin M
authors.initials: AM
authors.lastname: Alousi
authors.forename: Uday R
authors.initials: UR
authors.lastname: Popat
authors.forename: Chitra
authors.initials: C
authors.lastname: Hosing
authors.forename: Issa F
authors.initials: IF
authors.lastname: Khouri
authors.forename: Richard E
authors.initials: RE
authors.lastname: Champlin
authors.forename: Marcos J
authors.initials: MJ
authors.lastname: de Lima
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001792:Blood Platelets / Q000187:drug effects / Q000502:physiology*; D002648:Child; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000097:blood* / Q000188:drug therapy / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000097:blood* / Q000188:drug therapy / Q000601:surgery*; D011379:Prognosis; D012074:Remission Induction; D012189:Retrospective Studies; D016019:Survival Analysis; D019172:Transplantation Conditioning / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult