Autotransplantation versus HLA-matched unrelated donor transplantation for acute myeloid leukaemia: A retrospective analysis from the Center for International Blood and Marrow Transplant Research

Hillard M. Lazarus; Waleska S. Pérez; John P. Klein; Craig Kollman; B. Bate-Boyle; Christopher N. Bredeson; Robert Peter Gale; Robert B. Geller; Armand Keating; Mark R. Litzow; David I. Marks; Carole B. Miller; J. Douglas Rizzo; Thomas R. Spitzer; Daniel J. Weisdorf; Mei Jie Zhang; Mary M. Horowitz

doi:10.1111/j.1365-2141.2005.05947.x

Autotransplantation versus HLA-matched unrelated donor transplantation for acute myeloid leukaemia: A retrospective analysis from the Center for International Blood and Marrow Transplant Research

Hillard M. Lazarus, Waleska S. Pérez, John P. Klein, Craig Kollman, B. Bate-Boyle, Christopher N. Bredeson, Robert Peter Gale, Robert B. Geller, Armand Keating, Mark R. Litzow, David I. Marks, Carole B. Miller, J. Douglas Rizzo, Thomas R. Spitzer, Daniel J. Weisdorf, Mei Jie Zhang, Mary M. Horowitz

Hematology

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53 Scopus citations

Abstract

Most acute myeloid leukaemia (AML) patients lack human leucocyte antigen-identical sibling donors for transplantation. Autotransplants and unrelated donor (URD) transplants are therapeutic options. To compare autologous versus URD transplantation for AML in first (CR1) or second complete remission (CR2), we studied the outcomes of 668 autotransplants were compared with 476 URD transplants reported to the Center for International Blood and Marrow Transplant Research. Proportional hazards regression adjusted for differences in prognostic variables. In multivariate analyses transplant-related mortality (TRM) was significantly higher and relapse lower with URD transplantation. Adjusted 3-year survival probabilities were: in CR1 57 (53-61)% with autotransplants and 44 (37-51)% URD (P = 0.002), in CR2 46 (39-53)% and 33 (28-38)% respectively (P = 0.006). Adjusted 3-year leukaemia-free survival (LFS) probabilities were: CR1 53 (48-57)% with autotransplants and 43 (36-50)% with URD (P = 0.021), CR2 39 (32-46)% and 33 (27-38)% respectively (P = 0.169). Both autologous and URD transplantation produced prolonged LFS. High TRM offsets the superior antileukaemia effect of URD transplantation. This retrospective, observational database study showed that autotransplantation, in general, offered higher 3-year survival for AML patients in CR1 and CR2. Cytogenetics, however, were known in only two-thirds of patients and treatment bias cannot be eliminated.

Original language	English (US)
Pages (from-to)	755-769
Number of pages	15
Journal	British journal of haematology
Volume	132
Issue number	6
DOIs	https://doi.org/10.1111/j.1365-2141.2005.05947.x
State	Published - Mar 2006

Keywords

Acute myeloid leukaemia
Autograft
Bone marrow transplantation
Haematopoietic stem cell transplant
Unrelated allograft

ASJC Scopus subject areas

Hematology

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10.1111/j.1365-2141.2005.05947.x

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Lazarus, H. M., Pérez, W. S., Klein, J. P., Kollman, C., Bate-Boyle, B., Bredeson, C. N., Gale, R. P., Geller, R. B., Keating, A., Litzow, M. R., Marks, D. I., Miller, C. B., Douglas Rizzo, J., Spitzer, T. R., Weisdorf, D. J., Zhang, M. J., & Horowitz, M. M. (2006). Autotransplantation versus HLA-matched unrelated donor transplantation for acute myeloid leukaemia: A retrospective analysis from the Center for International Blood and Marrow Transplant Research. British journal of haematology, 132(6), 755-769. https://doi.org/10.1111/j.1365-2141.2005.05947.x

Autotransplantation versus HLA-matched unrelated donor transplantation for acute myeloid leukaemia: A retrospective analysis from the Center for International Blood and Marrow Transplant Research. / Lazarus, Hillard M.; Pérez, Waleska S.; Klein, John P. et al.
In: British journal of haematology, Vol. 132, No. 6, 03.2006, p. 755-769.

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

Lazarus, HM, Pérez, WS, Klein, JP, Kollman, C, Bate-Boyle, B, Bredeson, CN, Gale, RP, Geller, RB, Keating, A, Litzow, MR, Marks, DI, Miller, CB, Douglas Rizzo, J, Spitzer, TR, Weisdorf, DJ, Zhang, MJ & Horowitz, MM 2006, 'Autotransplantation versus HLA-matched unrelated donor transplantation for acute myeloid leukaemia: A retrospective analysis from the Center for International Blood and Marrow Transplant Research', British journal of haematology, vol. 132, no. 6, pp. 755-769. https://doi.org/10.1111/j.1365-2141.2005.05947.x

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abstract = "Most acute myeloid leukaemia (AML) patients lack human leucocyte antigen-identical sibling donors for transplantation. Autotransplants and unrelated donor (URD) transplants are therapeutic options. To compare autologous versus URD transplantation for AML in first (CR1) or second complete remission (CR2), we studied the outcomes of 668 autotransplants were compared with 476 URD transplants reported to the Center for International Blood and Marrow Transplant Research. Proportional hazards regression adjusted for differences in prognostic variables. In multivariate analyses transplant-related mortality (TRM) was significantly higher and relapse lower with URD transplantation. Adjusted 3-year survival probabilities were: in CR1 57 (53-61)% with autotransplants and 44 (37-51)% URD (P = 0.002), in CR2 46 (39-53)% and 33 (28-38)% respectively (P = 0.006). Adjusted 3-year leukaemia-free survival (LFS) probabilities were: CR1 53 (48-57)% with autotransplants and 43 (36-50)% with URD (P = 0.021), CR2 39 (32-46)% and 33 (27-38)% respectively (P = 0.169). Both autologous and URD transplantation produced prolonged LFS. High TRM offsets the superior antileukaemia effect of URD transplantation. This retrospective, observational database study showed that autotransplantation, in general, offered higher 3-year survival for AML patients in CR1 and CR2. Cytogenetics, however, were known in only two-thirds of patients and treatment bias cannot be eliminated.",

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AU - Keating, Armand

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AU - Marks, David I.

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AU - Horowitz, Mary M.

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AB - Most acute myeloid leukaemia (AML) patients lack human leucocyte antigen-identical sibling donors for transplantation. Autotransplants and unrelated donor (URD) transplants are therapeutic options. To compare autologous versus URD transplantation for AML in first (CR1) or second complete remission (CR2), we studied the outcomes of 668 autotransplants were compared with 476 URD transplants reported to the Center for International Blood and Marrow Transplant Research. Proportional hazards regression adjusted for differences in prognostic variables. In multivariate analyses transplant-related mortality (TRM) was significantly higher and relapse lower with URD transplantation. Adjusted 3-year survival probabilities were: in CR1 57 (53-61)% with autotransplants and 44 (37-51)% URD (P = 0.002), in CR2 46 (39-53)% and 33 (28-38)% respectively (P = 0.006). Adjusted 3-year leukaemia-free survival (LFS) probabilities were: CR1 53 (48-57)% with autotransplants and 43 (36-50)% with URD (P = 0.021), CR2 39 (32-46)% and 33 (27-38)% respectively (P = 0.169). Both autologous and URD transplantation produced prolonged LFS. High TRM offsets the superior antileukaemia effect of URD transplantation. This retrospective, observational database study showed that autotransplantation, in general, offered higher 3-year survival for AML patients in CR1 and CR2. Cytogenetics, however, were known in only two-thirds of patients and treatment bias cannot be eliminated.

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Autotransplantation versus HLA-matched unrelated donor transplantation for acute myeloid leukaemia: A retrospective analysis from the Center for International Blood and Marrow Transplant Research

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