Reducing the risk for transplantation-related mortality after allogeneic hematopoietic cell transplantation: How much progress has been made?

John T. Horan, Brent R. Logan, Manza A. Agovi-Johnson, Hillard M. Lazarus, Andrea A. Bacigalupo, Karen K. Ballen, Christopher N. Bredeson, Matthew H. Carabasi, Vikas Gupta, Gregory A. Hale, Hanna Jean Khoury, Mark B. Juckett, Mark R Litzow, Rodrigo Martino, Philip L. McCarthy, Franklin O. Smith, J. Douglas Rizzo, Marcelo C. Pasquini

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Abstract

Purpose: Transplantation-related mortality (TRM) is a major barrier to the success of allogeneic hematopoietic cell transplantation (HCT). Patients and Methods: We assessed changes in the incidence of TRM and overall survival from 1985 through 2004 in 5,972 patients younger than age 50 years who received myeloablative conditioning and HCT for acute myeloid leukemia (AML) in first complete remission (CR1) or second complete remission (CR2). Results: Among HLA-matched sibling donor transplantation recipients, the relative risks (RRs) for TRM were 0.5 and 0.3 for 2000 to 2004 compared with those for 1985 to 1989 in patients in CR1 and CR2, respectively (P < .001). The RRs for all causes of mortality in the latter period were 0.73 (P < .001) and 0.60 (P < .005) for the CR1 and CR2 groups, respectively. Among unrelated donor transplantation recipients, the RRs for TRM were 0.73 (P = .095) and 0.58 (P < .001) for 2000 to 2004 compared with those in 1990 to 1994 in the CR1 and CR2 groups, respectively. Reductions in mortality were observed in the CR2 group (RR, 0.74; P = .03) but not in the CR1 group. Conclusion: Our results suggest that innovations in transplantation care since the 1980s and 1990s have reduced the risk of TRM in patients undergoing allogeneic HCT for AML and that this reduction has been accompanied by improvements in overall survival.

Original languageEnglish (US)
Pages (from-to)805-813
Number of pages9
JournalJournal of Clinical Oncology
Volume29
Issue number7
DOIs
StatePublished - Mar 1 2011

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Cell Transplantation
Transplantation
Mortality
Acute Myeloid Leukemia
Unrelated Donors
Survival
Siblings
Tissue Donors
Incidence

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Horan, J. T., Logan, B. R., Agovi-Johnson, M. A., Lazarus, H. M., Bacigalupo, A. A., Ballen, K. K., ... Pasquini, M. C. (2011). Reducing the risk for transplantation-related mortality after allogeneic hematopoietic cell transplantation: How much progress has been made? Journal of Clinical Oncology, 29(7), 805-813. https://doi.org/10.1200/JCO.2010.32.5001

Reducing the risk for transplantation-related mortality after allogeneic hematopoietic cell transplantation : How much progress has been made? / Horan, John T.; Logan, Brent R.; Agovi-Johnson, Manza A.; Lazarus, Hillard M.; Bacigalupo, Andrea A.; Ballen, Karen K.; Bredeson, Christopher N.; Carabasi, Matthew H.; Gupta, Vikas; Hale, Gregory A.; Khoury, Hanna Jean; Juckett, Mark B.; Litzow, Mark R; Martino, Rodrigo; McCarthy, Philip L.; Smith, Franklin O.; Rizzo, J. Douglas; Pasquini, Marcelo C.

In: Journal of Clinical Oncology, Vol. 29, No. 7, 01.03.2011, p. 805-813.

Research output: Contribution to journalArticle

Horan, JT, Logan, BR, Agovi-Johnson, MA, Lazarus, HM, Bacigalupo, AA, Ballen, KK, Bredeson, CN, Carabasi, MH, Gupta, V, Hale, GA, Khoury, HJ, Juckett, MB, Litzow, MR, Martino, R, McCarthy, PL, Smith, FO, Rizzo, JD & Pasquini, MC 2011, 'Reducing the risk for transplantation-related mortality after allogeneic hematopoietic cell transplantation: How much progress has been made?', Journal of Clinical Oncology, vol. 29, no. 7, pp. 805-813. https://doi.org/10.1200/JCO.2010.32.5001
Horan, John T. ; Logan, Brent R. ; Agovi-Johnson, Manza A. ; Lazarus, Hillard M. ; Bacigalupo, Andrea A. ; Ballen, Karen K. ; Bredeson, Christopher N. ; Carabasi, Matthew H. ; Gupta, Vikas ; Hale, Gregory A. ; Khoury, Hanna Jean ; Juckett, Mark B. ; Litzow, Mark R ; Martino, Rodrigo ; McCarthy, Philip L. ; Smith, Franklin O. ; Rizzo, J. Douglas ; Pasquini, Marcelo C. / Reducing the risk for transplantation-related mortality after allogeneic hematopoietic cell transplantation : How much progress has been made?. In: Journal of Clinical Oncology. 2011 ; Vol. 29, No. 7. pp. 805-813.
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abstract = "Purpose: Transplantation-related mortality (TRM) is a major barrier to the success of allogeneic hematopoietic cell transplantation (HCT). Patients and Methods: We assessed changes in the incidence of TRM and overall survival from 1985 through 2004 in 5,972 patients younger than age 50 years who received myeloablative conditioning and HCT for acute myeloid leukemia (AML) in first complete remission (CR1) or second complete remission (CR2). Results: Among HLA-matched sibling donor transplantation recipients, the relative risks (RRs) for TRM were 0.5 and 0.3 for 2000 to 2004 compared with those for 1985 to 1989 in patients in CR1 and CR2, respectively (P < .001). The RRs for all causes of mortality in the latter period were 0.73 (P < .001) and 0.60 (P < .005) for the CR1 and CR2 groups, respectively. Among unrelated donor transplantation recipients, the RRs for TRM were 0.73 (P = .095) and 0.58 (P < .001) for 2000 to 2004 compared with those in 1990 to 1994 in the CR1 and CR2 groups, respectively. Reductions in mortality were observed in the CR2 group (RR, 0.74; P = .03) but not in the CR1 group. Conclusion: Our results suggest that innovations in transplantation care since the 1980s and 1990s have reduced the risk of TRM in patients undergoing allogeneic HCT for AML and that this reduction has been accompanied by improvements in overall survival.",
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T1 - Reducing the risk for transplantation-related mortality after allogeneic hematopoietic cell transplantation

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AU - Horan, John T.

AU - Logan, Brent R.

AU - Agovi-Johnson, Manza A.

AU - Lazarus, Hillard M.

AU - Bacigalupo, Andrea A.

AU - Ballen, Karen K.

AU - Bredeson, Christopher N.

AU - Carabasi, Matthew H.

AU - Gupta, Vikas

AU - Hale, Gregory A.

AU - Khoury, Hanna Jean

AU - Juckett, Mark B.

AU - Litzow, Mark R

AU - Martino, Rodrigo

AU - McCarthy, Philip L.

AU - Smith, Franklin O.

AU - Rizzo, J. Douglas

AU - Pasquini, Marcelo C.

PY - 2011/3/1

Y1 - 2011/3/1

N2 - Purpose: Transplantation-related mortality (TRM) is a major barrier to the success of allogeneic hematopoietic cell transplantation (HCT). Patients and Methods: We assessed changes in the incidence of TRM and overall survival from 1985 through 2004 in 5,972 patients younger than age 50 years who received myeloablative conditioning and HCT for acute myeloid leukemia (AML) in first complete remission (CR1) or second complete remission (CR2). Results: Among HLA-matched sibling donor transplantation recipients, the relative risks (RRs) for TRM were 0.5 and 0.3 for 2000 to 2004 compared with those for 1985 to 1989 in patients in CR1 and CR2, respectively (P < .001). The RRs for all causes of mortality in the latter period were 0.73 (P < .001) and 0.60 (P < .005) for the CR1 and CR2 groups, respectively. Among unrelated donor transplantation recipients, the RRs for TRM were 0.73 (P = .095) and 0.58 (P < .001) for 2000 to 2004 compared with those in 1990 to 1994 in the CR1 and CR2 groups, respectively. Reductions in mortality were observed in the CR2 group (RR, 0.74; P = .03) but not in the CR1 group. Conclusion: Our results suggest that innovations in transplantation care since the 1980s and 1990s have reduced the risk of TRM in patients undergoing allogeneic HCT for AML and that this reduction has been accompanied by improvements in overall survival.

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