Factors predicting long-term survival after T-cell depleted reduced intensity allogeneic stem cell transplantation for acute myeloid leukemia

Research output: Contribution to journalArticle

Authors

  • S Nagra
  • A Peniket
  • E Nikolousis
  • N Duncan
  • S Tauro
  • J Yin
  • E Liakopoulou
  • P Kottaridis
  • J Snowden
  • Donald Milligan
  • G Cook
  • B Tholouli
  • T Littlewood
  • K Peggs
  • P Vyas
  • S MacKinnon
  • N Russell

Abstract

Background Reduced intensity conditioning regimens permit the delivery of a potentially curative graft-versus-leukemia effect in older patients with acute myeloid leukemia. Although T-cell depletion is increasingly used to reduce the risk of graft-versus-host disease its impact on the graft-versus-leukemia effect and long-term outcome post-transplant is unknown. Design and Methods We have characterized pre- and post-transplant factors determining overall survival in 168 patients with acute myeloid leukemia transplanted using an alemtuzumab based reduced intensity conditioning regimen with a median duration of follow-up of 37 months. Results The 3-year overall survival for patients transplanted in CR1 or CR2/CR3 was 50% (95% CI, 38% to 62%) and 44% (95% CI, 31% to 56%), respectively compared to 15% (95% CI, 2% to 36%) for patients with relapsed/refractory disease. Multivariate analysis demonstrated that both survival and disease relapse were influenced by status at transplant (P=0.008) and presentation cytogenetics (P=0.01). Increased exposure to cyclosporine A (CsA) in the first 21 days post-transplant was associated with an increased relapse risk (P

Details

Original languageEnglish
Pages (from-to)989-995
Number of pages7
JournalHaematologica
Volume95
Issue number6
Publication statusPublished - 1 Jun 2010

Keywords

  • reduced intensity conditioning, acute myeloid leukemia, graft-versus-leukemia