title: Long-term follow-up of patients with acute myeloid leukemia surviving and free of disease recurrence for at least 2 years after autologous stem cell transplantation: A report from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation.
abstract: BACKGROUND
  Leukemia recurrence is a major cause of treatment failure after autologous stem cell transplantation for acute myeloid leukemia (AML). It usually occurs within the first 2 years after transplantation. The goal of the current retrospective study was to assess the follow-up of and characterize risk factors for outcome among patients who survived free of disease recurrence after this period.
  
  
  METHODS
  The analysis included 3567 adults (median age, 45 years) with AML who underwent autografting during the first (86% of patients) or second (14% of patients) complete remission between 1990 and 2008. The stem cell source was the bone marrow in 32% of patients or the peripheral blood in 68% of patients. The median follow-up was 6.9 years.
  
  
  RESULTS
  At 5 years and 10 years after transplantation, the probability of leukemia-free survival was 86% and 76%, respectively; the recurrence incidence was 11% and 16%, respectively; and the nonrecurrence mortality rate was 3% and 8%, respectively. The observed survival was decreased compared with the expected survival of the general European population. In a multivariate analysis, decreased probability of leukemia-free survival was demonstrated for patients who underwent peripheral blood autologous stem cell transplantation; had French-American-British subtypes M0, M6, or M7; and were of an older age. The same factors were found to be associated with an increased risk of disease recurrence. Nonrecurrence mortality was found to be affected by older age.
  
  
  CONCLUSIONS
  The results of the current analysis indicate that late recurrences remain a major concern after autologous stem cell transplantation among patients with AML, indicating the need for close monitoring of minimal residual disease and additional leukemic control measures after transplantation. Cancer 2016;122:1880-7. © 2016 American Cancer Society.
authors.affiliation: Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Gliwice Branch, Gliwice, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Czerw
authors.affiliation: Clinical Hematology and Cellular Therapy Department, The Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation Office, Hopital Saint-Antoine APHP, Paris, France.|INSERM UMRs 938, Paris, France.|Pierre and Marie Curie University, Paris, France.
authors.forename: Myriam
authors.initials: M
authors.lastname: Labopin
authors.affiliation: Clinical Hematology and Cellular Therapy Department, The Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation Office, Hopital Saint-Antoine APHP, Paris, France.|INSERM UMRs 938, Paris, France.|Pierre and Marie Curie University, Paris, France.
authors.forename: Norbert-Claude
authors.initials: NC
authors.lastname: Gorin
authors.affiliation: Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Gliwice Branch, Gliwice, Poland.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Giebel
authors.affiliation: Department of Transplantation and Cellular Therapy, Paoli Calmettes Institute, Marseille, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Blaise
authors.affiliation: Department of Cellular Biotechnology and Hematology, "LaSapienza" University, Rome, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Meloni
authors.affiliation: Department of Hematology and Cellular Therapy, University Hospital of Bordeaux, Bordeaux, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Pigneux
authors.affiliation: Bone Marrow Transplantation Unit, Department of Hematology, di Careggi Hospital, Florence, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Bosi
authors.affiliation: Bone Marrow Transplantation Centre Leiden, Leiden University Hospital, Leiden, The Netherlands.
authors.forename: Joan
authors.initials: J
authors.lastname: Veelken
authors.affiliation: Division of Hematology and Stem Cell Transplantation Unit, Cardarelli Hospital, Naples, Italy.
authors.forename: Felicetto
authors.initials: F
authors.lastname: Ferrara
authors.affiliation: Department of Hematology, Radboud University-Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors.forename: Nicolaas
authors.initials: N
authors.lastname: Schaap
authors.affiliation: Institute of Hematology and Medical Oncology, "L & A Seragnoli," St.Orsola-Malpighi University Hospital, Bologna University, Bologna, Italy.|Roberto M. Lemoli's current address: Division of Hematology, Department of Internal Medicine, University of Genoa, Genoa, Italy.
authors.forename: Roberto M
authors.initials: RM
authors.lastname: Lemoli
authors.affiliation: Department of Hematology, Erasmus University Medical Center Cancer Institute, Rotterdam, The Netherlands.
authors.forename: Jan J
authors.initials: JJ
authors.lastname: Cornelissen
authors.affiliation: INSERM UMRs 938, Paris, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Beohou
authors.affiliation: Clinical Hematology and Cellular Therapy Department, The Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation Office, Hopital Saint-Antoine APHP, Paris, France.|Hematology and Bone Marrow Transplantation, Chaim Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: Arnon
authors.initials: A
authors.lastname: Nagler
authors.affiliation: Clinical Hematology and Cellular Therapy Department, The Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation Office, Hopital Saint-Antoine APHP, Paris, France.|INSERM UMRs 938, Paris, France.|Pierre and Marie Curie University, Paris, France.
authors.forename: Mohamad
authors.initials: M
authors.lastname: Mohty
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005060:Europe / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D033581:Stem Cell Transplantation / Q000379:methods*; D014182:Transplantation, Autologous; D055815:Young Adult
keywords: acute myeloid leukemia (AML); autologous transplantation; follow-up; recurrence; risk factors; stem cell transplantation