Impact of early remission by induction therapy on allogeneic stem cell transplantation for acute myeloid leukemia with an intermediate-risk karyotype in first complete remission
For patients with acute myeloid leukemia (AML) early achievement of remission during induction treatment is an important predictor for long‐term outcome irrespective of the type of consolidation therapy employed. Here, we retrospectively examined the prognostic impact of early remission (ER) vs. del...
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Veröffentlicht in: | European journal of haematology 2015-05, Vol.94 (5), p.431-438 |
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creator | Hemmati, Philipp G. Terwey, Theis H. Na, Il-Kang le Coutre, Philipp Jehn, Christian F. Vuong, Lam G. Dörken, Bernd Arnold, Renate |
description | For patients with acute myeloid leukemia (AML) early achievement of remission during induction treatment is an important predictor for long‐term outcome irrespective of the type of consolidation therapy employed. Here, we retrospectively examined the prognostic impact of early remission (ER) vs. delayed remission (DR) in a cohort of 132 AML patients with an intermediate‐risk karyotype undergoing allogeneic stem cell transplantation (alloSCT) in first complete remission (CR1). In contrast to patients showing DR, patients achieving ER had a significantly higher 3‐yr overall survival (OS) and disease‐free survival (DFS) of 76% vs. 54% (P = 0.03) and 76% vs. 53% (P = 0.03). Likewise, 3 yr after alloSCT the cumulative incidence of relapse (CI‐R) was significantly lower in the ER subgroup as compared to patients achieving DR, that is, 10% vs. 35% (P = 0.004), whereas non‐relapse mortality (NRM) did not differ significantly. Multivariate analysis identified DR as an independent prognosticator for an inferior DFS (HR 3.37, P = 0.002) and a higher CI‐R (HR 3.55, P = 0.002). Taken together, these data may indicate that the rapid achievement of remission predicts a favorable outcome in patients with intermediate‐risk AML undergoing alloSCT in CR1. In turn, the adverse effect of DR may not be fully overcome by alloSCT. |
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Here, we retrospectively examined the prognostic impact of early remission (ER) vs. delayed remission (DR) in a cohort of 132 AML patients with an intermediate‐risk karyotype undergoing allogeneic stem cell transplantation (alloSCT) in first complete remission (CR1). In contrast to patients showing DR, patients achieving ER had a significantly higher 3‐yr overall survival (OS) and disease‐free survival (DFS) of 76% vs. 54% (P = 0.03) and 76% vs. 53% (P = 0.03). Likewise, 3 yr after alloSCT the cumulative incidence of relapse (CI‐R) was significantly lower in the ER subgroup as compared to patients achieving DR, that is, 10% vs. 35% (P = 0.004), whereas non‐relapse mortality (NRM) did not differ significantly. Multivariate analysis identified DR as an independent prognosticator for an inferior DFS (HR 3.37, P = 0.002) and a higher CI‐R (HR 3.55, P = 0.002). Taken together, these data may indicate that the rapid achievement of remission predicts a favorable outcome in patients with intermediate‐risk AML undergoing alloSCT in CR1. In turn, the adverse effect of DR may not be fully overcome by alloSCT.</description><identifier>ISSN: 0902-4441</identifier><identifier>EISSN: 1600-0609</identifier><identifier>DOI: 10.1111/ejh.12449</identifier><identifier>PMID: 25220715</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>acute myeloid leukemia ; Adolescent ; Adult ; Aged ; allogeneic stem cell transplantation ; Antineoplastic Agents - therapeutic use ; early remission ; Female ; Hematopoietic Stem Cell Transplantation ; Humans ; Induction Chemotherapy ; Leukemia, Myeloid, Acute - diagnosis ; Leukemia, Myeloid, Acute - drug therapy ; Leukemia, Myeloid, Acute - mortality ; Leukemia, Myeloid, Acute - pathology ; Male ; Middle Aged ; Multivariate Analysis ; Recurrence ; reduced intensity conditioning ; Remission Induction ; Retrospective Studies ; Survival Analysis ; Time Factors ; Transplantation, Homologous ; Treatment Outcome</subject><ispartof>European journal of haematology, 2015-05, Vol.94 (5), p.431-438</ispartof><rights>2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd</rights><rights>2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3989-d8bd8f49180d9c4c0f60f8a2dedc3df40691b06c217153a2083073f4cdcdc2423</citedby><cites>FETCH-LOGICAL-c3989-d8bd8f49180d9c4c0f60f8a2dedc3df40691b06c217153a2083073f4cdcdc2423</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fejh.12449$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fejh.12449$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25220715$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hemmati, Philipp G.</creatorcontrib><creatorcontrib>Terwey, Theis H.</creatorcontrib><creatorcontrib>Na, Il-Kang</creatorcontrib><creatorcontrib>le Coutre, Philipp</creatorcontrib><creatorcontrib>Jehn, Christian F.</creatorcontrib><creatorcontrib>Vuong, Lam G.</creatorcontrib><creatorcontrib>Dörken, Bernd</creatorcontrib><creatorcontrib>Arnold, Renate</creatorcontrib><title>Impact of early remission by induction therapy on allogeneic stem cell transplantation for acute myeloid leukemia with an intermediate-risk karyotype in first complete remission</title><title>European journal of haematology</title><addtitle>Eur J Haematol</addtitle><description>For patients with acute myeloid leukemia (AML) early achievement of remission during induction treatment is an important predictor for long‐term outcome irrespective of the type of consolidation therapy employed. Here, we retrospectively examined the prognostic impact of early remission (ER) vs. delayed remission (DR) in a cohort of 132 AML patients with an intermediate‐risk karyotype undergoing allogeneic stem cell transplantation (alloSCT) in first complete remission (CR1). In contrast to patients showing DR, patients achieving ER had a significantly higher 3‐yr overall survival (OS) and disease‐free survival (DFS) of 76% vs. 54% (P = 0.03) and 76% vs. 53% (P = 0.03). Likewise, 3 yr after alloSCT the cumulative incidence of relapse (CI‐R) was significantly lower in the ER subgroup as compared to patients achieving DR, that is, 10% vs. 35% (P = 0.004), whereas non‐relapse mortality (NRM) did not differ significantly. Multivariate analysis identified DR as an independent prognosticator for an inferior DFS (HR 3.37, P = 0.002) and a higher CI‐R (HR 3.55, P = 0.002). Taken together, these data may indicate that the rapid achievement of remission predicts a favorable outcome in patients with intermediate‐risk AML undergoing alloSCT in CR1. In turn, the adverse effect of DR may not be fully overcome by alloSCT.</description><subject>acute myeloid leukemia</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>allogeneic stem cell transplantation</subject><subject>Antineoplastic Agents - therapeutic use</subject><subject>early remission</subject><subject>Female</subject><subject>Hematopoietic Stem Cell Transplantation</subject><subject>Humans</subject><subject>Induction Chemotherapy</subject><subject>Leukemia, Myeloid, Acute - diagnosis</subject><subject>Leukemia, Myeloid, Acute - drug therapy</subject><subject>Leukemia, Myeloid, Acute - mortality</subject><subject>Leukemia, Myeloid, Acute - pathology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Recurrence</subject><subject>reduced intensity conditioning</subject><subject>Remission Induction</subject><subject>Retrospective Studies</subject><subject>Survival Analysis</subject><subject>Time Factors</subject><subject>Transplantation, Homologous</subject><subject>Treatment Outcome</subject><issn>0902-4441</issn><issn>1600-0609</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kcFyFCEURSlLy0yiC3_AYqmLToBmupulNRUz0agbrSwpBh4OGbppga7Yn-UfhskksxMWQHHerXffRegdJee0rAu4255Txrl4gRa0IaQiDREv0YIIwirOOT1BpyndEUKYoO1rdMKWjJGWLhfo33U_Kp1xsBhU9DOO0LuUXBjwZsZuMJPO-0feQlTjjMtVeR9-wwBO45Shxxq8xzmqIY1eDVk98jZErPSUAfcz-OAM9jDtirbC9y5vsRqKeIbYg3EqQxVd2uGdinPI8wjlD1sXU8Y69KOHInPs6w16ZZVP8PbpPEO_Pl_-XK2rmx9X16tPN5WuRScq021MZ7mgHTFCc01sQ2ynmAGja2M5aQTdkEYzWuZQK0a6mrS15dqUzTirz9CHg-4Yw58JUpalgb1XNUCYkqRNy8qABWkK-vGA6hhSimDlGF1fzEhK5D4hWRKSjwkV9v2T7LQp5o_kcyQFuDgA987D_H8lefll_SxZHSpcyePvsULFnWzaul3K2-9Xki7Xq6-33Te5rh8AwFGuqA</recordid><startdate>201505</startdate><enddate>201505</enddate><creator>Hemmati, Philipp G.</creator><creator>Terwey, Theis H.</creator><creator>Na, Il-Kang</creator><creator>le Coutre, Philipp</creator><creator>Jehn, Christian F.</creator><creator>Vuong, Lam G.</creator><creator>Dörken, Bernd</creator><creator>Arnold, Renate</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201505</creationdate><title>Impact of early remission by induction therapy on allogeneic stem cell transplantation for acute myeloid leukemia with an intermediate-risk karyotype in first complete remission</title><author>Hemmati, Philipp G. ; Terwey, Theis H. ; Na, Il-Kang ; le Coutre, Philipp ; Jehn, Christian F. ; Vuong, Lam G. ; Dörken, Bernd ; Arnold, Renate</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3989-d8bd8f49180d9c4c0f60f8a2dedc3df40691b06c217153a2083073f4cdcdc2423</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>acute myeloid leukemia</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>allogeneic stem cell transplantation</topic><topic>Antineoplastic Agents - therapeutic use</topic><topic>early remission</topic><topic>Female</topic><topic>Hematopoietic Stem Cell Transplantation</topic><topic>Humans</topic><topic>Induction Chemotherapy</topic><topic>Leukemia, Myeloid, Acute - diagnosis</topic><topic>Leukemia, Myeloid, Acute - drug therapy</topic><topic>Leukemia, Myeloid, Acute - mortality</topic><topic>Leukemia, Myeloid, Acute - pathology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Recurrence</topic><topic>reduced intensity conditioning</topic><topic>Remission Induction</topic><topic>Retrospective Studies</topic><topic>Survival Analysis</topic><topic>Time Factors</topic><topic>Transplantation, Homologous</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hemmati, Philipp G.</creatorcontrib><creatorcontrib>Terwey, Theis H.</creatorcontrib><creatorcontrib>Na, Il-Kang</creatorcontrib><creatorcontrib>le Coutre, Philipp</creatorcontrib><creatorcontrib>Jehn, Christian F.</creatorcontrib><creatorcontrib>Vuong, Lam G.</creatorcontrib><creatorcontrib>Dörken, Bernd</creatorcontrib><creatorcontrib>Arnold, Renate</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of haematology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hemmati, Philipp G.</au><au>Terwey, Theis H.</au><au>Na, Il-Kang</au><au>le Coutre, Philipp</au><au>Jehn, Christian F.</au><au>Vuong, Lam G.</au><au>Dörken, Bernd</au><au>Arnold, Renate</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of early remission by induction therapy on allogeneic stem cell transplantation for acute myeloid leukemia with an intermediate-risk karyotype in first complete remission</atitle><jtitle>European journal of haematology</jtitle><addtitle>Eur J Haematol</addtitle><date>2015-05</date><risdate>2015</risdate><volume>94</volume><issue>5</issue><spage>431</spage><epage>438</epage><pages>431-438</pages><issn>0902-4441</issn><eissn>1600-0609</eissn><abstract>For patients with acute myeloid leukemia (AML) early achievement of remission during induction treatment is an important predictor for long‐term outcome irrespective of the type of consolidation therapy employed. Here, we retrospectively examined the prognostic impact of early remission (ER) vs. delayed remission (DR) in a cohort of 132 AML patients with an intermediate‐risk karyotype undergoing allogeneic stem cell transplantation (alloSCT) in first complete remission (CR1). In contrast to patients showing DR, patients achieving ER had a significantly higher 3‐yr overall survival (OS) and disease‐free survival (DFS) of 76% vs. 54% (P = 0.03) and 76% vs. 53% (P = 0.03). Likewise, 3 yr after alloSCT the cumulative incidence of relapse (CI‐R) was significantly lower in the ER subgroup as compared to patients achieving DR, that is, 10% vs. 35% (P = 0.004), whereas non‐relapse mortality (NRM) did not differ significantly. Multivariate analysis identified DR as an independent prognosticator for an inferior DFS (HR 3.37, P = 0.002) and a higher CI‐R (HR 3.55, P = 0.002). Taken together, these data may indicate that the rapid achievement of remission predicts a favorable outcome in patients with intermediate‐risk AML undergoing alloSCT in CR1. In turn, the adverse effect of DR may not be fully overcome by alloSCT.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>25220715</pmid><doi>10.1111/ejh.12449</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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subjects | acute myeloid leukemia Adolescent Adult Aged allogeneic stem cell transplantation Antineoplastic Agents - therapeutic use early remission Female Hematopoietic Stem Cell Transplantation Humans Induction Chemotherapy Leukemia, Myeloid, Acute - diagnosis Leukemia, Myeloid, Acute - drug therapy Leukemia, Myeloid, Acute - mortality Leukemia, Myeloid, Acute - pathology Male Middle Aged Multivariate Analysis Recurrence reduced intensity conditioning Remission Induction Retrospective Studies Survival Analysis Time Factors Transplantation, Homologous Treatment Outcome |
title | Impact of early remission by induction therapy on allogeneic stem cell transplantation for acute myeloid leukemia with an intermediate-risk karyotype in first complete remission |
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