title: Superior transplantation outcomes of 8/8-matched unrelated donors as well as matched siblings to autologous transplantation for acute myeloid leukemia with intermediate cytogenetics in first remission.
abstract: OBJECTIVE
  For patients with acute myeloid leukemia in first complete remission (AML CR1) lacking HLA-matched sibling donors (MSD), 8/8-matched unrelated donors (URD) are mostly used in cases with poor-risk features. For AML CR1 with intermediate cytogenetics, however, the benefit of 8/8-matched URD should be compared with non-allogeneic therapies as well as MSD.
  
  
  METHODS
  To address this issue, we assessed the transplantation outcomes of 8/8-matched URD (n = 54) compared with MSD (n = 145) or autologous transplantation (n = 89) for AML CR1 with intermediate cytogenetics.
  
  
  RESULTS
  In multivariate analyses, 8/8-matched URD had comparable 6-yr overall survival (OS, P = 0.997), disease-free survival (DFS, P = 0.951), and relapse (P = 0.672) to MSD, whereas 8/8-matched URD had a higher OS (P = 0.070) and DFS (P = 0.035) with lower relapse (P = 0.009) than autologous transplantation. No difference in non-relapse mortality was observed according to donor type. Notably, these equivalent or superior outcomes of 8/8-matched URD compared with MSD or autologous transplantation, respectively, were particularly evident in patients without poor-risk features (n = 200), such as older age, hyperleukocytosis at diagnosis, and myelodysplasia-related changes, who are not usual candidates for URD transplantation.
  
  
  CONCLUSIONS
  These results indicate that 8/8-matched URD are feasible next option in AML CR1 with intermediate cytogenetics, when lacking MSD, even in patients without poor-risk features.
authors: Division of Hematology, Department of Internal Medicine, Catholic Blood and Marrow Transplantation Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors: Byung-Sik
authors: BS
authors: Cho
authors: Jung-Ho
authors: JH
authors: Kim
authors: Jae-Ho
authors: JH
authors: Yoon
authors: Seung-Hwan
authors: SH
authors: Shin
authors: Seung-Ah
authors: SA
authors: Yahng
authors: Sung-Eun
authors: SE
authors: Lee
authors: Ki-Seong
authors: KS
authors: Eom
authors: Yoo-Jin
authors: YJ
authors: Kim
authors: Seok
authors: S
authors: Lee
authors: Chang-Ki
authors: CK
authors: Min
authors: Seok-Goo
authors: SG
authors: Cho
authors: Dong-Wook
authors: DW
authors: Kim
authors: Jong-Wook
authors: JW
authors: Lee
authors: Woo-Sung
authors: WS
authors: Min
authors: Chong-Won
authors: CW
authors: Park
authors: Hee-Je
authors: HJ
authors: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D020732:Cytogenetic Analysis; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000235:genetics / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D035781:Siblings; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D061349:Unrelated Donors; D055815:Young Adult