The outcome of allogeneic HSCT in older AML patients is determined by disease biology and not by the donor type: an analysis of 96 allografted AML patients ≥ 50 years from the Czech acute leukaemia clinical register (alert)

• Published in: Neoplasma Vol. 60; no. 5; p. 576
• Main Authors: Jindra, P, Muzik, J, Indrak, K, Zak, P, Sabty, F A, Kozak, T, Cetkovsky, P, Karas, V Koza M, Raida, L, Szotkowski, T
• Format: Journal Article
• Language: English
• Published: Slovakia 2013
• Subjects: Aged; Czechoslovakia; Disease-Free Survival; Female; Hematopoietic Stem Cell Transplantation - mortality; Humans; Kaplan-Meier Estimate; Leukemia, Myeloid, Acute - genetics; Leukemia, Myeloid, Acute - mortality; Leukemia, Myeloid, Acute - pathology; Male; Middle Aged; Proportional Hazards Models; Registries; Retrospective Studies; Tissue Donors; Transplantation, Homologous; Treatment Outcome; Czechoslovakia
• ISSN: 0028-2685
• DOI: 10.4149/neo_2013_075

Older patients with AML have poor prognosis after chemotherapy and allo-SCT was historically limited to the young patients. In the multicentre retrospective study we analyzed 96 consecutive AML patients ≥ 50 years allografted with related (n=59) or unrelated (n=37) donor. The 2- year OS and DFS rates were 45 % and 42 % for the whole group. The corresponding figures for related patients were 48% and 42% whereas for unrelated 42% and 42%, respectively (OS p=0,721, DFS p= 0,896). The cumulative incidences of relapse (28% of all patients) and NRM mortality (26%) were low with no significant differences among related and unrelated cohorts. Multivariate analysis revealed the only major independent variables associated with an inferior OS were unfavourable cytogenetics (RR 3.36; CI 1.66-6.83; p=0.001) and advanced disease status (RR 2.30; CI 1.21-4.37; p=0.011). Unfavourable cytogenetics (RR 3.00; CI 1.50-5.99; p=0.002) and advanced disease at SCT (RR 2.27; CI 1.22-4.22; p=0.009) were also the only independent variables associated with inferior DFS. In conclusion, our analysis indicates that outcomes of allografted AML patients aged ≥ 50 years are determined by cytogenetic risk category and disease status at transplantation and not by the type of donor.