Allogeneic Hematopoietic Stem Cell Transplantation Following the Use of Hypomethylating Agents among Patients with Relapsed or Refractory AML: Findings from an International Retrospective Study

Maximilian Stahl; Michelle DeVeaux; Pau Montesinos; Raphaël Itzykson; Ellen K. Ritchie; Mikkael A. Sekeres; Navneet Majhail; John Barnard; Nikolai A. Podoltsev; Andrew M. Brunner; Rami S. Komrokji; Vijaya R. Bhatt; Aref Al-Kali; Thomas Cluzeau; Valeria Santini; Gail J. Roboz; Pierre Fenaux; Mark Litzow; Amir T. Fathi; Sarah Perreault; Tae Kon Kim; Thomas Prebet; Norbert Vey; Vivek Verma; Guido Kobbe; Juan Bergua; Josefina Serrano; Steven D. Gore; Amer M. Zeidan

doi:10.1016/j.bbmt.2018.03.025

Allogeneic Hematopoietic Stem Cell Transplantation Following the Use of Hypomethylating Agents among Patients with Relapsed or Refractory AML: Findings from an International Retrospective Study

Maximilian Stahl, Michelle DeVeaux, Pau Montesinos, Raphaël Itzykson, Ellen K. Ritchie, Mikkael A. Sekeres, Navneet Majhail, John Barnard, Nikolai A. Podoltsev, Andrew M. Brunner, Rami S. Komrokji, Vijaya R. Bhatt, Aref Al-Kali, Thomas Cluzeau, Valeria Santini, Gail J. Roboz, Pierre Fenaux, Mark Litzow, Amir T. Fathi, Sarah PerreaultTae Kon Kim, Thomas Prebet, Norbert Vey, Vivek Verma, Guido Kobbe, Juan Bergua, Josefina Serrano, Steven D. Gore, Amer M. Zeidan

Hematology

Research output: Contribution to journal › Article › peer-review

3 Scopus citations

Abstract

Patients with primary refractory or relapsed acute myeloid leukemia (RR-AML) have very poor prognosis. Due to limited treatment options, some patients are treated with hypomethylating agents (HMAs) due to their tolerability. Little is known about the role of allogeneic hematopoietic stem cell transplantation (HSCT) following HMA therapy in this setting. We retrospectively analyzed an international cohort of 655 RR-AML patients who received HMA therapy to study patterns and outcomes with HSCT. Only 37 patients (5.6%) patients underwent HSCT after HMA therapy. The conditioning regimen was myeloablative in 57% and nonmyeloablative in 43%. Patients received matched unrelated donor, matched sibling, haploidentical and mismatched unrelated HSCT in 56%, 24%, 16% and 4% of cases, respectively. Acute GvHD and chronic GvHD were observed in 40% and 17% of patients. While the median OS for the entire cohort of patients was 15.3 months (95% CI 9.5 – 21.7 months), OS reached 29.7 months (95% CI 7.01 – not-reached) for patients who achieved a complete remission (CR) to HMA and no intervening therapies between HMA therapy and HSCT. Our study suggests that HMA therapy can effectively bridge some patients with RR-AML to HSCT.

Original language	English (US)
Pages (from-to)	1754-1758
Number of pages	5
Journal	Biology of Blood and Marrow Transplantation
Volume	24
Issue number	8
DOIs	https://doi.org/10.1016/j.bbmt.2018.03.025
State	Published - Aug 2018

Keywords

AML
Hypomethylating agents
Survival
Transplant

ASJC Scopus subject areas

Hematology
Transplantation

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10.1016/j.bbmt.2018.03.025

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Stahl, M., DeVeaux, M., Montesinos, P., Itzykson, R., Ritchie, E. K., Sekeres, M. A., Majhail, N., Barnard, J., Podoltsev, N. A., Brunner, A. M., Komrokji, R. S., Bhatt, V. R., Al-Kali, A., Cluzeau, T., Santini, V., Roboz, G. J., Fenaux, P., Litzow, M., Fathi, A. T., ... Zeidan, A. M. (2018). Allogeneic Hematopoietic Stem Cell Transplantation Following the Use of Hypomethylating Agents among Patients with Relapsed or Refractory AML: Findings from an International Retrospective Study. Biology of Blood and Marrow Transplantation, 24(8), 1754-1758. https://doi.org/10.1016/j.bbmt.2018.03.025

Allogeneic Hematopoietic Stem Cell Transplantation Following the Use of Hypomethylating Agents among Patients with Relapsed or Refractory AML: Findings from an International Retrospective Study. / Stahl, Maximilian; DeVeaux, Michelle; Montesinos, Pau et al.
In: Biology of Blood and Marrow Transplantation, Vol. 24, No. 8, 08.2018, p. 1754-1758.

Research output: Contribution to journal › Article › peer-review

Stahl, M, DeVeaux, M, Montesinos, P, Itzykson, R, Ritchie, EK, Sekeres, MA, Majhail, N, Barnard, J, Podoltsev, NA, Brunner, AM, Komrokji, RS, Bhatt, VR, Al-Kali, A, Cluzeau, T, Santini, V, Roboz, GJ, Fenaux, P, Litzow, M, Fathi, AT, Perreault, S, Kim, TK, Prebet, T, Vey, N, Verma, V, Kobbe, G, Bergua, J, Serrano, J, Gore, SD & Zeidan, AM 2018, 'Allogeneic Hematopoietic Stem Cell Transplantation Following the Use of Hypomethylating Agents among Patients with Relapsed or Refractory AML: Findings from an International Retrospective Study', Biology of Blood and Marrow Transplantation, vol. 24, no. 8, pp. 1754-1758. https://doi.org/10.1016/j.bbmt.2018.03.025

Stahl M, DeVeaux M, Montesinos P, Itzykson R, Ritchie EK, Sekeres MA et al. Allogeneic Hematopoietic Stem Cell Transplantation Following the Use of Hypomethylating Agents among Patients with Relapsed or Refractory AML: Findings from an International Retrospective Study. Biology of Blood and Marrow Transplantation. 2018 Aug;24(8):1754-1758. doi: 10.1016/j.bbmt.2018.03.025

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title = "Allogeneic Hematopoietic Stem Cell Transplantation Following the Use of Hypomethylating Agents among Patients with Relapsed or Refractory AML: Findings from an International Retrospective Study",

abstract = "Patients with primary refractory or relapsed acute myeloid leukemia (RR-AML) have very poor prognosis. Due to limited treatment options, some patients are treated with hypomethylating agents (HMAs) due to their tolerability. Little is known about the role of allogeneic hematopoietic stem cell transplantation (HSCT) following HMA therapy in this setting. We retrospectively analyzed an international cohort of 655 RR-AML patients who received HMA therapy to study patterns and outcomes with HSCT. Only 37 patients (5.6%) patients underwent HSCT after HMA therapy. The conditioning regimen was myeloablative in 57% and nonmyeloablative in 43%. Patients received matched unrelated donor, matched sibling, haploidentical and mismatched unrelated HSCT in 56%, 24%, 16% and 4% of cases, respectively. Acute GvHD and chronic GvHD were observed in 40% and 17% of patients. While the median OS for the entire cohort of patients was 15.3 months (95% CI 9.5 – 21.7 months), OS reached 29.7 months (95% CI 7.01 – not-reached) for patients who achieved a complete remission (CR) to HMA and no intervening therapies between HMA therapy and HSCT. Our study suggests that HMA therapy can effectively bridge some patients with RR-AML to HSCT.",

keywords = "AML, Hypomethylating agents, Survival, Transplant",

author = "Maximilian Stahl and Michelle DeVeaux and Pau Montesinos and Rapha{\"e}l Itzykson and Ritchie, {Ellen K.} and Sekeres, {Mikkael A.} and Navneet Majhail and John Barnard and Podoltsev, {Nikolai A.} and Brunner, {Andrew M.} and Komrokji, {Rami S.} and Bhatt, {Vijaya R.} and Aref Al-Kali and Thomas Cluzeau and Valeria Santini and Roboz, {Gail J.} and Pierre Fenaux and Mark Litzow and Fathi, {Amir T.} and Sarah Perreault and Kim, {Tae Kon} and Thomas Prebet and Norbert Vey and Vivek Verma and Guido Kobbe and Juan Bergua and Josefina Serrano and Gore, {Steven D.} and Zeidan, {Amer M.}",

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T1 - Allogeneic Hematopoietic Stem Cell Transplantation Following the Use of Hypomethylating Agents among Patients with Relapsed or Refractory AML

T2 - Findings from an International Retrospective Study

AU - Stahl, Maximilian

AU - DeVeaux, Michelle

AU - Montesinos, Pau

AU - Itzykson, Raphaël

AU - Ritchie, Ellen K.

AU - Sekeres, Mikkael A.

AU - Majhail, Navneet

AU - Barnard, John

AU - Podoltsev, Nikolai A.

AU - Brunner, Andrew M.

AU - Komrokji, Rami S.

AU - Bhatt, Vijaya R.

AU - Al-Kali, Aref

AU - Cluzeau, Thomas

AU - Santini, Valeria

AU - Roboz, Gail J.

AU - Fenaux, Pierre

AU - Litzow, Mark

AU - Fathi, Amir T.

AU - Perreault, Sarah

AU - Kim, Tae Kon

AU - Prebet, Thomas

AU - Vey, Norbert

AU - Verma, Vivek

AU - Kobbe, Guido

AU - Bergua, Juan

AU - Serrano, Josefina

AU - Gore, Steven D.

AU - Zeidan, Amer M.

PY - 2018/8

Y1 - 2018/8

N2 - Patients with primary refractory or relapsed acute myeloid leukemia (RR-AML) have very poor prognosis. Due to limited treatment options, some patients are treated with hypomethylating agents (HMAs) due to their tolerability. Little is known about the role of allogeneic hematopoietic stem cell transplantation (HSCT) following HMA therapy in this setting. We retrospectively analyzed an international cohort of 655 RR-AML patients who received HMA therapy to study patterns and outcomes with HSCT. Only 37 patients (5.6%) patients underwent HSCT after HMA therapy. The conditioning regimen was myeloablative in 57% and nonmyeloablative in 43%. Patients received matched unrelated donor, matched sibling, haploidentical and mismatched unrelated HSCT in 56%, 24%, 16% and 4% of cases, respectively. Acute GvHD and chronic GvHD were observed in 40% and 17% of patients. While the median OS for the entire cohort of patients was 15.3 months (95% CI 9.5 – 21.7 months), OS reached 29.7 months (95% CI 7.01 – not-reached) for patients who achieved a complete remission (CR) to HMA and no intervening therapies between HMA therapy and HSCT. Our study suggests that HMA therapy can effectively bridge some patients with RR-AML to HSCT.

AB - Patients with primary refractory or relapsed acute myeloid leukemia (RR-AML) have very poor prognosis. Due to limited treatment options, some patients are treated with hypomethylating agents (HMAs) due to their tolerability. Little is known about the role of allogeneic hematopoietic stem cell transplantation (HSCT) following HMA therapy in this setting. We retrospectively analyzed an international cohort of 655 RR-AML patients who received HMA therapy to study patterns and outcomes with HSCT. Only 37 patients (5.6%) patients underwent HSCT after HMA therapy. The conditioning regimen was myeloablative in 57% and nonmyeloablative in 43%. Patients received matched unrelated donor, matched sibling, haploidentical and mismatched unrelated HSCT in 56%, 24%, 16% and 4% of cases, respectively. Acute GvHD and chronic GvHD were observed in 40% and 17% of patients. While the median OS for the entire cohort of patients was 15.3 months (95% CI 9.5 – 21.7 months), OS reached 29.7 months (95% CI 7.01 – not-reached) for patients who achieved a complete remission (CR) to HMA and no intervening therapies between HMA therapy and HSCT. Our study suggests that HMA therapy can effectively bridge some patients with RR-AML to HSCT.

KW - AML

KW - Hypomethylating agents

KW - Survival

KW - Transplant

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Allogeneic Hematopoietic Stem Cell Transplantation Following the Use of Hypomethylating Agents among Patients with Relapsed or Refractory AML: Findings from an International Retrospective Study

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