title: In patients older than 55 years with AML in first CR, should we search for a matched unrelated donor when an old sibling donor is available?
abstract: Allogeneic hematopoietic transplantation is increasingly used in patients aged 55 years or more with AML. The question of whether outcomes can be improved with an allele-level 8/8 HLA-matched unrelated donor (MUD) rather than an older HLA-matched sibling (MSD, more than 55 years) is still unanswered. We thus analyzed outcomes in 714 patients aged 55 years and older with AML in first CR (CR1) who received PBSCs after a reduced-intensity conditioning hematopoietic cell transplant from a MUD (n=310) or a MSD (n=404) in a recent period (2005-2010). The 3-year cumulative incidences (CIs) of non-relapse mortality were 17% and 23% with MSD and MUD, respectively (P=0.17). The 3-year CIs of relapse were 37% and 30%, respectively (P=0.12), resulting in a 3-year CI of leukemia-free survival of 46% and 47%, respectively (P=0.51). The 3-year overall survival was 49% with both MSD and MUD. In conclusion, HLA-identical sibling donors aged 55 years or more should not be excluded because of age for patients aged 55 years and older with AML in CR1.
authors.affiliation: Service d'Hématologie Greffe, AP-HP-Hôpital Saint Louis, Paris, France.|Paris Diderot University, EA 3518, Paris, France.
authors.forename: R
authors.initials: R
authors.lastname: Peffault de Latour
authors.affiliation: ALWP-EBMT, AP-HP-Hôpital Saint Antoine, Paris, France.|Service d'Hématologie Clinique et de Thérapie Cellulaire, AP-HP-Hôpital Saint Antoine, Paris, France.|Universite Pierre et Marie Curie, Paris, France.|INSERM, UMRs 938, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Labopin
authors.affiliation: Hematology Department, Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Cornelissen
authors.affiliation: CHU Bordeaux-Hôpital Haut-levêque, Pessac, France.
authors.forename: S
authors.initials: S
authors.lastname: Vigouroux
authors.affiliation: BMT unit, Centre for Clinical Haematology-Queen Elizabeth Hospital, Birmingham, UK.
authors.forename: C
authors.initials: C
authors.lastname: Craddock
authors.affiliation: Institut Paoli Calmettes-Unité de Transplantation et de Thérapie Cellulaire-Inserm UMR 891, Marseille, France.
authors.forename: D
authors.initials: D
authors.lastname: Blaise
authors.affiliation: Department of Hematology, Hopital de Purpan-CHU, Toulouse, France.
authors.forename: A
authors.initials: A
authors.lastname: Huyn
authors.affiliation: Bone Marrow Transplant Unit L 4043, Rigshospitalet, Copenhagen, Denmark.
authors.forename: L
authors.initials: L
authors.lastname: Vindelov
authors.affiliation: Department of Hematology, University Hospital Gasthuisberg, Leuven, Belgium.
authors.forename: J
authors.initials: J
authors.lastname: Maertens
authors.affiliation: Department of Hematology, Hopital Hotel Dieu-CHU, Nantes, France.
authors.forename: P
authors.initials: P
authors.lastname: Chevallier
authors.affiliation: CHU Lapeyronie-Service d'Hématologie et Oncologie, Montpellier, France.
authors.forename: N
authors.initials: N
authors.lastname: Fegueux
authors.affiliation: Service d'Hématologie Greffe, AP-HP-Hôpital Saint Louis, Paris, France.|Université Paris Diderot, Paris, France.|INSERM 1160, Paris, France.
authors.forename: G
authors.initials: G
authors.lastname: Socié
authors.affiliation: Department of Hematology, University Hospital, Grenoble, France.|University Medical Centre UMR 525 CNRS, Grenoble, France.
authors.forename: J Y
authors.initials: JY
authors.lastname: Cahn
authors.affiliation: Department of Hematology, Utrecht, The Netherlands.
authors.forename: E
authors.initials: E
authors.lastname: Petersen
authors.affiliation: Department Internal Medicine Hematology/Oncology, University Hospital Maastricht, Maastricht, The Netherlands.
authors.forename: H
authors.initials: H
authors.lastname: Schouten
authors.affiliation: Department of Onco-Hematologiy, CHU Hautepierre, Strasbourg, France.
authors.forename: B
authors.initials: B
authors.lastname: Lioure
authors.affiliation: Division of Hematology and BMT, Nottingham City Hospital, Nottingham, UK.
authors.forename: N
authors.initials: N
authors.lastname: Russell
authors.affiliation: Hospital Clínico-Servicio de Hematología, Salamanca, Spain.
authors.forename: L L
authors.initials: LL
authors.lastname: Corral
authors.affiliation: Hematology and BMT Unit, EBMT CIC 813, San Raffaele Scientific Institute, Milano, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Ciceri
authors.affiliation: ALWP-EBMT, AP-HP-Hôpital Saint Antoine, Paris, France.|Division of Hematology and Bone Marrow Transplantation, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Nagler
authors.affiliation: ALWP-EBMT, AP-HP-Hôpital Saint Antoine, Paris, France.|Service d'Hématologie Clinique et de Thérapie Cellulaire, AP-HP-Hôpital Saint Antoine, Paris, France.|Universite Pierre et Marie Curie, Paris, France.|INSERM, UMRs 938, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Mohty
mesh_terms: D000367:Age Factors; D000368:Aged; D064591:Allografts; D018572:Disease-Free Survival; D005260:Female; D000069585:Filgrastim; D005500:Follow-Up Studies; D006085:Graft Survival; D006086:Graft vs Host Disease / Q000188:drug therapy / Q000209:etiology / Q000276:immunology / Q000517:prevention & control; D018380:Hematopoietic Stem Cell Transplantation; D006648:Histocompatibility; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D015470:Leukemia, Myeloid, Acute / Q000628:therapy*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D035781:Siblings; D009927:Tissue and Organ Procurement; D019172:Transplantation Conditioning; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D000069585:Filgrastim