title: Assessing the efficacy of allogeneic hematopoietic stem cells transplantation (allo-HSCT) by analyzing survival end points in defined groups of acute myeloid leukemia patients: a retrospective, multicenter Polish Adult Leukemia Group study.
abstract: The importance of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for survival outcomes in patients with acute myeloid leukemia (AML) currently remains unclear. The study aimed to compare measures of clinical treatment for patients with AML in CR1 (the first complete remission) with or without being subjected to allo-HSCT. These consisted of leukemia-free survival (LFS), overall survival (OS), cumulative incidence of relapse (CIR), and non-relapse mortality disease (NRM). Subjects were 622 patients, median age of 44, forming part of the prospective, randomized, and multicenter clinical Polish Adult Leukemia Group trials during 1999-2008. The Mantel-Byar approach was used to assess allo-HSCT on survival endpoints, accounting for a changing transplant status. Undergoing allo-HSCT significantly improved the LFS and OS for the entire group of patients with AML in CR1, along with the DAC induction subgroup and for the group with unfavorable cytogenetics aged 41-60. The CIR demonstrated that allo-HSCT reduced the risk of relapse for patients with AML in CR1 and those with an unfavorable cytogenetic risk. In addition, the NRM analysis showed that allo-HSCT significantly reduced the risk of death unrelated to relapse for the entire group of AML patients in CR1 and aged 41-60. The allo-HSCT treatment particularly benefitted survival for the AML in CR1 group having an unfavorable cytogenetic prognosis.
authors.affiliation: Department of Cancer Prevention, School of Public Health, Medical University of Silesia, Katowice, Poland.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Grosicki
authors.affiliation: Department of Bone Marrow Transplantation, Branch Gliwice, Comprehensive Cancer Center M. Sklodowska-Curie Memorial Institute, Gliwice, Poland.
authors.forename: Jerzy
authors.initials: J
authors.lastname: Holowiecki
authors.affiliation: Department of Haematology, Hematopoietic Malignancies and BMT, Medical University, Wroclaw, Poland.
authors.forename: Kazimierz
authors.initials: K
authors.lastname: Kuliczkowski
authors.affiliation: Department of Haematology, Collegium Medicum, Jagiellonian University, Cracow, Poland.
authors.forename: Aleksander
authors.initials: A
authors.lastname: Skotnicki
authors.affiliation: Department of Haematology and Transplantology, Medical University, Gdansk, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Hellmann
authors.affiliation: Department of Haematology and Bone Marrow Transplantation, Medical University of Silesia, Katowice, Poland.
authors.forename: Slawomira
authors.initials: S
authors.lastname: Kyrcz-Krzemien
authors.affiliation: Samodzielna Pracownia Transplantologii Klinicznej, Uniwersytet Medyczny, Lublin, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Dmoszynska
authors.affiliation: Military Medical Institute, Warsaw, Poland.
authors.forename: Kazimierz
authors.initials: K
authors.lastname: Sułek
authors.affiliation: Department of Hematology, Medical University, Bialystok, Poland.
authors.forename: Janusz
authors.initials: J
authors.lastname: Kloczko
authors.affiliation: Department of Hematology, Oncology and Internal Medicine, Medical University, Warsaw, Poland.
authors.forename: Wieslaw W
authors.initials: WW
authors.lastname: Jedrzejczak
authors.affiliation: Department of Haematology, Institute of Haematology and Transfusion Medicine, Warsaw, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Warzocha
authors.affiliation: Department of Internal Medicine and Haematology, SPSK Nr 1, Szczecin, Poland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Zdziarska
authors.affiliation: Department of Haematology, Copernicus Memorial Hospital, Medical University, Lodz, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Wierzbowska
authors.affiliation: Department of Haematology, Copernicus Memorial Hospital, Medical University, Lodz, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Pluta
authors.affiliation: Department of Hematology and Proliferative Diseases of The Hematopoietic Systems, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Mieczyslaw
authors.initials: M
authors.lastname: Komarnicki
authors.affiliation: Department of Bone Marrow Transplantation, Branch Gliwice, Comprehensive Cancer Center M. Sklodowska-Curie Memorial Institute, Gliwice, Poland.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Giebel
mesh_terms: D000293:Adolescent; D000328:Adult; D064591:Allografts; D002869:Chromosome Aberrations; D018572:Disease-Free Survival; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000235:genetics / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011044:Poland / Q000453:epidemiology; D012189:Retrospective Studies; D015996:Survival Rate