title: The outcome of allogeneic HSCT in older AML patients is determined by disease biology and not by the donor type: an analysis of 96 allografted AML patients ≥ 50 years from the Czech acute leukaemia clinical register (alert).
abstract: Older patients with AML have poor prognosis after chemotherapy and allo-SCT was historically limited to the young patients. In the multicentre retrospective study we analyzed 96 consecutive AML patients ≥ 50 years allografted with related (n=59) or unrelated (n=37) donor. The 2- year OS and DFS rates were 45 % and 42 % for the whole group. The corresponding figures for related patients were 48% and 42% whereas for unrelated 42% and 42%, respectively (OS p=0,721, DFS p= 0,896). The cumulative incidences of relapse (28% of all patients) and NRM mortality (26%) were low with no significant differences among related and unrelated cohorts. Multivariate analysis revealed the only major independent variables associated with an inferior OS were unfavourable cytogenetics (RR 3.36; CI 1.66-6.83; p=0.001) and advanced disease status (RR 2.30; CI 1.21-4.37; p=0.011). Unfavourable cytogenetics (RR 3.00; CI 1.50-5.99; p=0.002) and advanced disease at SCT (RR 2.27; CI 1.22-4.22; p=0.009) were also the only independent variables associated with inferior DFS. In conclusion, our analysis indicates that outcomes of allografted AML patients aged ≥ 50 years are determined by cytogenetic risk category and disease status at transplantation and not by the type of donor.
authors.affiliation: University Hospital, Pilsen, Czech Republic. jindra@fnplzen.cz
authors.forename: P
authors.initials: P
authors.lastname: Jindra
authors.forename: J
authors.initials: J
authors.lastname: Muzik
authors.forename: K
authors.initials: K
authors.lastname: Indrak
authors.forename: P
authors.initials: P
authors.lastname: Zak
authors.forename: F A
authors.initials: FA
authors.lastname: Sabty
authors.forename: T
authors.initials: T
authors.lastname: Kozak
authors.forename: P
authors.initials: P
authors.lastname: Cetkovsky
authors.forename: V Koza M
authors.initials: VK
authors.lastname: Karas
authors.forename: L
authors.initials: L
authors.lastname: Raida
authors.forename: T
authors.initials: T
authors.lastname: Szotkowski
mesh_terms: D000368:Aged; D003604:Czechoslovakia; D018572:Disease-Free Survival; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000401:mortality*; D006801:Humans; D053208:Kaplan-Meier Estimate; D015470:Leukemia, Myeloid, Acute / Q000235:genetics / Q000401:mortality* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012042:Registries; D012189:Retrospective Studies; D014019:Tissue Donors; D014184:Transplantation, Homologous; D016896:Treatment Outcome