title: Treatment strategies in patients with AML or high-risk myelodysplastic syndrome relapsed after Allo-SCT.
abstract: Non-relapse mortality after Allo-SCT has significantly decreased over the last years. Nevertheless, relapse remains a major cause for post SCT mortality in patients with AML and high-risk myelodysplastic syndrome (MDS). In this retrospective single-center analysis, we have analyzed the treatment outcomes of 108 patients with AML or MDS, who relapsed after Allo-SCT. Seventy of these patients (65%) were treated with salvage therapies containing chemotherapy alone, allogeneic cell-based treatment or the combination of both. Thirty-eight patients (35%) received palliative treatment. Median OS after diagnosis of relapse was 130 days. Compared with patients who received chemotherapy alone, response to salvage therapy was significantly improved in patients treated with a combination of chemo- and allogeneic cell-based therapy (CR rate 57% vs 13%, P=0.002). Among risk factors concerning pretreatment characteristics, disease status before first Allo-SCT, and details of transplantation, only the time interval from Allo-SCT to relapse was an independent predictor of response to salvage therapy and OS. These data confirmed that time to relapse after transplantation is an important prognostic factor. Up to now, only patients eligible for treatment regimens containing allogeneic cell-based interventions achieved relevant response rates.
authors.affiliation: Department of Internal Medicine A, Hematology and Oncology, University of Muenster, Muenster, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Sauer
authors.affiliation: Department of Internal Medicine A, Hematology and Oncology, University of Muenster, Muenster, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Silling
authors.affiliation: Department of Internal Medicine A, Hematology and Oncology, University of Muenster, Muenster, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Groth
authors.affiliation: Department of Internal Medicine A, Hematology and Oncology, University of Muenster, Muenster, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Rosenow
authors.affiliation: Department of Internal Medicine A, Hematology and Oncology, University of Muenster, Muenster, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Krug
authors.affiliation: Institute of Biostatistics and Clinical Research, University of Muenster, Muenster, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Görlich
authors.affiliation: Department of Internal Medicine A, Hematology and Oncology, University of Muenster, Muenster, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Evers
authors.affiliation: Department of Internal Medicine A, Hematology and Oncology, University of Muenster, Muenster, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Albring
authors.affiliation: Institute of Human Genetics, University of Muenster, Muenster, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Besoke
authors.affiliation: Department of Internal Medicine A, Hematology and Oncology, University of Muenster, Muenster, Germany.
authors.forename: R M
authors.initials: RM
authors.lastname: Mesters
authors.affiliation: 1] Department of Internal Medicine A, Hematology and Oncology, University of Muenster, Muenster, Germany [2] Department of Medicine IV, Hematology and Oncology, University of Halle, Halle, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Müller-Tidow
authors.affiliation: Department of Internal Medicine A, Hematology and Oncology, University of Muenster, Muenster, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Kessler
authors.affiliation: Department of Internal Medicine A, Hematology and Oncology, University of Muenster, Muenster, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Büchner
authors.affiliation: Department of Internal Medicine A, Hematology and Oncology, University of Muenster, Muenster, Germany.
authors.forename: W E
authors.initials: WE
authors.lastname: Berdel
authors.affiliation: Department of Internal Medicine A, Hematology and Oncology, University of Muenster, Muenster, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Stelljes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D064591:Allografts; D018572:Disease-Free Survival; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000401:mortality* / Q000628:therapy*; D012008:Recurrence; D012189:Retrospective Studies; D016879:Salvage Therapy; D015996:Survival Rate; D013997:Time Factors