Comparison of umbilical cord blood allogeneic stem-cell transplantation (SCT) vs auto-SCT for adult acute myeloid leukemia patients in second complete remission at transplant: a retrospective study on behalf of the SFGM-TC.
Fiche publication
Date publication
septembre 2014
Auteurs
Membres identifiés du Cancéropôle Est :
Pr DECONINCK Eric
Tous les auteurs :
Chevallier P, Labopin M, Socie G, Rubio MT, Blaise D, Vigouroux S, Huynh A, Michallet M, Bay JO, Maury S, Yakoub-Agha I, Fegueux N, Deconinck E, Contentin N, Maillard N, Bulabois CE, Francois S, Oumedaly R, Raus N, Mohty M
Lien Pubmed
Résumé
This retrospective study considered the outcomes of 181 acute myeloid leukemia (AML) patients transplanted in second complete remission (CR2) between January 2005 and April 2012 and who received either a myeloablative autologous stem cell transplant (Auto-SCT; n=82; median age: 48 years; median follow-up: 45 months) or an umbilical cord blood (UCB) allogeneic SCT (n=99, median age: 46 years; median follow-up: 36 months; conditioning regimens: myeloablative n=21, reduced n=78; single unit n=37, double units n=62). Although the Auto group showed a significant better prognostic profile at transplant, with longer median interval between diagnosis and time of graft, higher incidence of good-risk cytogenetics and lower number of previously transplanted patients, 3-year OS and LFS were similar between both groups (Auto: 59+-6% vs 50+-6%, p=0.45; and 57+-6% vs 46+-6%, p=0.37). In multivariate analysis, UCB allo-SCT was associated with lower relapse incidence (HR: 0.3, 95%CI: 0.11-0.82, p=0.02) but higher non relapse mortality (NRM) (HR: 4.16; 95%CI: 1.46-11.9, p=0.008). Results from this large study suggest that UCB allo-SCT provides better disease control than auto-SCT, which is especially important in the setting of high risk disease. However this disease control advantage is counterbalanced by higher toxicity, highlighting the need for novel approaches aiming to decrease NRM after UCB allo-SCT. This article is protected by copyright. All rights reserved.
Référence
Eur J Haematol. 2014 Sep 19