Outcome of treatment after first relapse in younger adults with acute myeloid leukemia initially treated by the ALFA-9802 trial.
Forty-seven percent of adults with acute myeloid leukemia (AML) who entered the ALFA-9802 trial and achieved a first complete remission (CR) experienced a first relapse. We examined the outcome of these 190 adult patients. Eighty-four patients (44%) achieved a second CR. The median overall survival (OS) after relapse was 8.9 months with a 2-year OS at 25%. Factors predicting a better outcome after relapse were stem cell transplant (SCT) performed in second CR and a first CR duration >1 year. Risk groups defined at the time of diagnosis and treatment received in first CR also influenced the outcome after relapse. The best results were obtained in patients with core binding factor (CBF)-AML, while patients initially defined as favorable intermediate risk showed a similar outcome after relapse than those initially entering the poor risk group. We conclude that most adult patients with recurring AML could not be rescued using current available therapies, although allogeneic SCT remains the best therapeutic option at this stage of the disease.
Department of Hematology, Hôpital Edouard Herriot, Lyon, France. xavier.thomas@chu-lyon.fr
Xavier
X
Thomas
Emmanuel
E
Raffoux
Aline
A
Renneville
Cécile
C
Pautas
Stéphane
S
de Botton
Thierry
T
de Revel
Oumedaly
O
Reman
Christine
C
Terré
Claude
C
Gardin
Youcef
Y
Chelghoum
Nicolas
N
Boissel
Bruno
B
Quesnel
Catherine
C
Cordonnier
Jean-Henri
JH
Bourhis
Mohamed
M
Elhamri
Pierre
P
Fenaux
Claude
C
Preudhomme
Gérard
G
Socié
Mauricette
M
Michallet
Sylvie
S
Castaigne
Hervé
H
Dombret
D000293:Adolescent; D000328:Adult; D000465:Algorithms; D002986:Clinical Trials as Topic; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D012074:Remission Induction; D016879:Salvage Therapy / Q000379:methods; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult