title: Equivalent outcome of autologous stem cell transplantation and reduced intensity conditioning stem cell transplantation in acute myeloid leukemia patients with t(8;21).
abstract: We analyzed the outcome of stem cell transplantation (SCT) for 59 acute myeloid leukemia (AML) patients with t(8;21). The 5-year overall and disease-free survival (OS and DFS) were 70.2 and 68.4%, respectively. The 5-year cumulative incidence of relapse (CIR) and nonrelapse mortality were 16.9 and 13.6%, respectively. OS and DFS in the reduced-intensity conditioning (RIC)-SCT group (70.4%) were not different from in the autologous SCT (ASCT) group (72.4 and 69.0%, respectively). Age was a factor affecting OS (p = 0.007) and DFS (p = 0.008) in the ASCT group, but not in the RIC-SCT group. In the ASCT group, lack of the X chromosome (-X) and an age of >50 years were associated with inferior survival; however, these differences disappeared in the RIC-SCT group. CIR was significantly higher in patients with -X than in those without -X only in the ASCT group (p = 0.038), i.e. not in the RIC-SCT group. ASCT and RIC-SCT are equally effective for the intensification of postremission treatment of AML patients with t(8;21). The subgroups with advanced age or -X should be preferentially considered for RIC-SCT, rather than ASCT. Further investigations with randomized prospective trials of a sizeable study population are warranted.
authors.affiliation: Division of Hematology, Department of Internal Medicine, Catholic Blood and Marrow Transplantation Center, Seoul St. Mary's Hospital, Seoul, Republic of Korea.
authors.forename: Ki-Seong
authors.initials: KS
authors.lastname: Eom
authors.forename: Hee-Je
authors.initials: HJ
authors.lastname: Kim
authors.forename: Byung-Sik
authors.initials: BS
authors.lastname: Cho
authors.forename: Sung Eun
authors.initials: SE
authors.lastname: Lee
authors.forename: Seung-Ah
authors.initials: SA
authors.lastname: Yahng
authors.forename: Jae-Ho
authors.initials: JH
authors.lastname: Yoon
authors.forename: Seung-Hwan
authors.initials: SH
authors.lastname: Shin
authors.forename: Young-Woo
authors.initials: YW
authors.lastname: Jeon
authors.forename: Jung-Ho
authors.initials: JH
authors.lastname: Kim
authors.forename: Yoo-Jin
authors.initials: YJ
authors.lastname: Kim
authors.forename: Seok
authors.initials: S
authors.lastname: Lee
authors.forename: Chang-Ki
authors.initials: CK
authors.lastname: Min
authors.forename: Seok-Goo
authors.initials: SG
authors.lastname: Cho
authors.forename: Dong-Wook
authors.initials: DW
authors.lastname: Kim
authors.forename: Jong-Wook
authors.initials: JW
authors.lastname: Lee
authors.forename: Woo-Sung
authors.initials: WS
authors.lastname: Min
authors.forename: Chong-Won
authors.initials: CW
authors.lastname: Park
mesh_terms: D000293:Adolescent; D000328:Adult; D064592:Autografts; D002891:Chromosomes, Human, Pair 21 / Q000235:genetics*; D002898:Chromosomes, Human, Pair 8 / Q000235:genetics*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015994:Incidence; D015470:Leukemia, Myeloid, Acute / Q000235:genetics / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D033581:Stem Cell Transplantation; D015996:Survival Rate; D014178:Translocation, Genetic; D019172:Transplantation Conditioning