Comparison of reduced-intensity hematopoietic cell transplantation with chemotherapy in patients age 60-70 years with acute myelogenous leukemia in first remission

Sherif S. Farag, Kati Maharry, Mei Jie Zhang, Waleska S. Pérez, Stephen L. George, Krzysztof Mrózek, John DiPersio, Donald W. Bunjes, Guido Marcucci, Maria R. Baer, Mitchell Cairo, Edward Copelan, Corey S. Cutler, Luis Isola, Hillard M. Lazarus, Mark R. Litzow, David I. Marks, Olle Ringdén, David A. Rizzieri, Robert SoifferRichard A. Larson, Martin S. Tallman, Clara D. Bloomfield, Daniel J. Weisdorf

Research output: Contribution to journalArticlepeer-review

83 Scopus citations

Abstract

We compared the outcomes of patients age 60-70 years with acute myelogenous leukemia receiving reduced-intensity allogeneic hematopoietic cell transplantation (HCT) in first remission (CR1) reported to the Center for International Blood and Marrow Research (n = 94) with the outcomes in patients treated with induction and postremission chemotherapy on Cancer and Leukemia Group B protocols (n = 96). All patients included had been in CR1 for at least 4 months. The HCT recipients were slightly younger than the chemotherapy patients (median age, 63 years vs 65 years; P <.001), but there were no significant between-group differences in the proportion with therapy-related leukemia or in different cytogenetic risk groups. Time from diagnosis to CR1 was longer for the HCT recipients (median, 44 days vs 38 days; P =.031). Allogeneic HCT was associated with significantly lower risk of relapse (32% vs 81% at 3 years; P <.001), higher nonrelapse mortality (36% vs 4% at 3 years; P <.001), and longer leukemia-free survival (32% vs 15% at 3 years; P =.001). Although overall survival was longer for HCT recipients, the difference was not statistically significant (37% vs 25% at 3 years; P =.08). Our findings suggest that reduced-intensity conditioning allogeneic HCT in patients age 60-70 with acute myelogenous leukemia in CR1 reduces relapse and improves leukemia-free survival. Strategies that reduce nonrelapse mortality may yield significant improvements in overall survival.

Original languageEnglish (US)
Pages (from-to)1796-1803
Number of pages8
JournalBiology of Blood and Marrow Transplantation
Volume17
Issue number12
DOIs
StatePublished - Dec 2011

Keywords

  • Acute myeloid leukemia
  • Allogeneic
  • Chemotherapy
  • Reduced-intensity

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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