Allogeneic hematopoietic cell transplantation compared to chemotherapy consolidation in older acute myeloid leukemia (AML) patients 60–75 years in first complete remission (CR1): an alliance (A151509), SWOG, ECOG-ACRIN, and CIBMTR study
The preferred post-remission therapy for older patients with acute myeloid leukemia (AML) in first complete remission (CR1) remains uncertain. In this retrospective, multicenter study, we compared the outcomes for older AML patients (age 60–77 years) receiving allogeneic hematopoietic cell transplan...
Gespeichert in:
| Veröffentlicht in: | Leukemia 2019-11, Vol.33 (11), p.2599-2609 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 2609 |
|---|---|
| container_issue | 11 |
| container_start_page | 2599 |
| container_title | Leukemia |
| container_volume | 33 |
| creator | Ustun, Celalettin Le-Rademacher, Jennifer Wang, Hai-Lin Othus, Megan Sun, Zhuoxin Major, Brittny Zhang, Mei-Jie Storrick, Elizabeth Lafky, Jacqueline M. Chow, Selina Mrózek, Krzysztof Attar, Eyal C. Nand, Such Bloomfield, Clara D. Cripe, Larry D. Tallman, Martin S. Appelbaum, Frederick Larson, Richard A. Marcucci, Guido Roboz, Gail J. Uy, Geoffrey L. Stone, Richard M. Jatoi, Aminah Shea, Thomas C. de Lima, Marcos Foran, James M. Sandmaier, Brenda M. Litzow, Mark R. Erba, Harry P. Hurria, Arti Weisdorf, Daniel J. Artz, Andrew S. |
| description | The preferred post-remission therapy for older patients with acute myeloid leukemia (AML) in first complete remission (CR1) remains uncertain. In this retrospective, multicenter study, we compared the outcomes for older AML patients (age 60–77 years) receiving allogeneic hematopoietic cell transplantation (alloHCT) (
n
= 431) with those treated on prospective National Clinical Trials Network induction and nontransplantation chemotherapy (CT) consolidation trials (
n
= 211). AlloHCT patients were younger (median age: 64.2 versus 67.9 years,
p
|
| doi_str_mv | 10.1038/s41375-019-0477-x |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6842042</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A605035350</galeid><sourcerecordid>A605035350</sourcerecordid><originalsourceid>FETCH-LOGICAL-c567t-1aa1997a5876ef9f8169295b53c626e54d4ff24b7824f5c80c824538328ba133</originalsourceid><addsrcrecordid>eNp1ks2O0zAUhSMEYoaBB2CDLCGhVmrATuz8zAKpREOp1KFSqcTScpObNoNjB9tB0x3vwBvyADwDzmQYfiRWtnW_c-zre4LgKcEvCY6zV5aSOGUhJnmIaZqG1_eCU0LTJGSMkfvBKc6yNEzyiJ4Ej6y9wngoJg-Dk5jgNCYsPg1-zKXUe1DQlOgArXC60w04fypBSuSMULaTQjnhGq1QqdtOGKiQ06j0vHYHMKI7-oKyWjbViDUKaVmBQaLsHaD2CFI3FZLQf4K2EWgyv1xNUedhUM6iBH__-i1l6AjC2EFcN8a6m8skeL3xImsH40mxIdNzJBQSUjZCleC9CCMM59MZ-vBxvZihi2K9COfFZvl-5sEKFcs3l9sNsq6vjo-DB7WQFp7crmfB9u3FtngXrtaLZTFfhSVLUhcSIUiep4JlaQJ1XmfE_2LOdiwukygBRita1xHdpVlEa1ZmuPQbFmdxlO0EieOz4PVo2_W7FqrSd2mE5J1pWmGOXIuG_11RzYHv9ReeZDTCNPIGk1sDoz_3YB33PzBMRCjQveVRFJMc5wnNPfr8H_RK90b57riHIkZZzrCnXozUXkjgBxDSHfzA-mFcls8T7BkW34BkBEujrTVQ372aYD6kjo-p4z51fEgdv_aaZ3-2e6f4FTMPRCNgfUntwfx-4_9dfwLwheNk</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2312545950</pqid></control><display><type>article</type><title>Allogeneic hematopoietic cell transplantation compared to chemotherapy consolidation in older acute myeloid leukemia (AML) patients 60–75 years in first complete remission (CR1): an alliance (A151509), SWOG, ECOG-ACRIN, and CIBMTR study</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Ustun, Celalettin ; Le-Rademacher, Jennifer ; Wang, Hai-Lin ; Othus, Megan ; Sun, Zhuoxin ; Major, Brittny ; Zhang, Mei-Jie ; Storrick, Elizabeth ; Lafky, Jacqueline M. ; Chow, Selina ; Mrózek, Krzysztof ; Attar, Eyal C. ; Nand, Such ; Bloomfield, Clara D. ; Cripe, Larry D. ; Tallman, Martin S. ; Appelbaum, Frederick ; Larson, Richard A. ; Marcucci, Guido ; Roboz, Gail J. ; Uy, Geoffrey L. ; Stone, Richard M. ; Jatoi, Aminah ; Shea, Thomas C. ; de Lima, Marcos ; Foran, James M. ; Sandmaier, Brenda M. ; Litzow, Mark R. ; Erba, Harry P. ; Hurria, Arti ; Weisdorf, Daniel J. ; Artz, Andrew S.</creator><creatorcontrib>Ustun, Celalettin ; Le-Rademacher, Jennifer ; Wang, Hai-Lin ; Othus, Megan ; Sun, Zhuoxin ; Major, Brittny ; Zhang, Mei-Jie ; Storrick, Elizabeth ; Lafky, Jacqueline M. ; Chow, Selina ; Mrózek, Krzysztof ; Attar, Eyal C. ; Nand, Such ; Bloomfield, Clara D. ; Cripe, Larry D. ; Tallman, Martin S. ; Appelbaum, Frederick ; Larson, Richard A. ; Marcucci, Guido ; Roboz, Gail J. ; Uy, Geoffrey L. ; Stone, Richard M. ; Jatoi, Aminah ; Shea, Thomas C. ; de Lima, Marcos ; Foran, James M. ; Sandmaier, Brenda M. ; Litzow, Mark R. ; Erba, Harry P. ; Hurria, Arti ; Weisdorf, Daniel J. ; Artz, Andrew S.</creatorcontrib><description>The preferred post-remission therapy for older patients with acute myeloid leukemia (AML) in first complete remission (CR1) remains uncertain. In this retrospective, multicenter study, we compared the outcomes for older AML patients (age 60–77 years) receiving allogeneic hematopoietic cell transplantation (alloHCT) (
n
= 431) with those treated on prospective National Clinical Trials Network induction and nontransplantation chemotherapy (CT) consolidation trials (
n
= 211). AlloHCT patients were younger (median age: 64.2 versus 67.9 years,
p
< 0.001), but more frequently had high-risk AML (high WBC, secondary AML, and unfavorable cytogenetics). Overall survival (OS) was worse in alloHCT during the first 9 months after CR1 (HR = 1.52,
p
= 0.02), but was significantly better thereafter (HR = 0.53,
p
< 0.0001) relative to CT. Treatment-related mortality (TRM) following HCT was worse in the first 9 months (HR = 2.8, 95% CI: 1.5–5.2,
p
= 0.0009), while post-HCT relapse was significantly less frequent beyond 9 months (HR = 0.42, 95% CI: 0.29–0.61,
p
< 0.0001). Despite higher early TRM, alloHCT recipients had superior long-term OS [29% (24–34%) versus CT 13.8% (9–21%) at 5 years]. Although this is a retrospective analysis with potential biases, it indicates that alloHCT led to heightened early risks from TRM, yet reduced relapse and superior long-term survival relative to CT in older AML patients in CR1.</description><identifier>ISSN: 0887-6924</identifier><identifier>ISSN: 1476-5551</identifier><identifier>EISSN: 1476-5551</identifier><identifier>DOI: 10.1038/s41375-019-0477-x</identifier><identifier>PMID: 31073153</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>631/67/1059/99 ; 631/67/71 ; 96/100 ; Acute myeloid leukemia ; Aged ; Antineoplastic Agents - therapeutic use ; Cancer ; Cancer Research ; Chemotherapy ; Clinical trials ; Consolidation ; Critical Care Medicine ; Cytogenetics ; Disease-Free Survival ; Female ; Hematology ; Hematopoietic Stem Cell Transplantation ; Hematopoietic stem cells ; Humans ; Intensive ; Internal Medicine ; Leukemia ; Leukemia, Myeloid, Acute - drug therapy ; Leukemia, Myeloid, Acute - therapy ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Multivariate Analysis ; Myeloid leukemia ; Oncology ; Patients ; Remission ; Remission (Medicine) ; Remission Induction ; Retrospective Studies ; Risk Factors ; Stem cell transplantation ; Survival ; Transplantation ; Transplantation, Homologous ; Treatment Outcome ; United States</subject><ispartof>Leukemia, 2019-11, Vol.33 (11), p.2599-2609</ispartof><rights>Springer Nature Limited 2019</rights><rights>COPYRIGHT 2019 Nature Publishing Group</rights><rights>Springer Nature Limited 2019.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c567t-1aa1997a5876ef9f8169295b53c626e54d4ff24b7824f5c80c824538328ba133</citedby><cites>FETCH-LOGICAL-c567t-1aa1997a5876ef9f8169295b53c626e54d4ff24b7824f5c80c824538328ba133</cites><orcidid>0000-0002-2234-7430 ; 0000-0001-6896-6213 ; 0000-0002-8568-4522</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1038/s41375-019-0477-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1038/s41375-019-0477-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31073153$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ustun, Celalettin</creatorcontrib><creatorcontrib>Le-Rademacher, Jennifer</creatorcontrib><creatorcontrib>Wang, Hai-Lin</creatorcontrib><creatorcontrib>Othus, Megan</creatorcontrib><creatorcontrib>Sun, Zhuoxin</creatorcontrib><creatorcontrib>Major, Brittny</creatorcontrib><creatorcontrib>Zhang, Mei-Jie</creatorcontrib><creatorcontrib>Storrick, Elizabeth</creatorcontrib><creatorcontrib>Lafky, Jacqueline M.</creatorcontrib><creatorcontrib>Chow, Selina</creatorcontrib><creatorcontrib>Mrózek, Krzysztof</creatorcontrib><creatorcontrib>Attar, Eyal C.</creatorcontrib><creatorcontrib>Nand, Such</creatorcontrib><creatorcontrib>Bloomfield, Clara D.</creatorcontrib><creatorcontrib>Cripe, Larry D.</creatorcontrib><creatorcontrib>Tallman, Martin S.</creatorcontrib><creatorcontrib>Appelbaum, Frederick</creatorcontrib><creatorcontrib>Larson, Richard A.</creatorcontrib><creatorcontrib>Marcucci, Guido</creatorcontrib><creatorcontrib>Roboz, Gail J.</creatorcontrib><creatorcontrib>Uy, Geoffrey L.</creatorcontrib><creatorcontrib>Stone, Richard M.</creatorcontrib><creatorcontrib>Jatoi, Aminah</creatorcontrib><creatorcontrib>Shea, Thomas C.</creatorcontrib><creatorcontrib>de Lima, Marcos</creatorcontrib><creatorcontrib>Foran, James M.</creatorcontrib><creatorcontrib>Sandmaier, Brenda M.</creatorcontrib><creatorcontrib>Litzow, Mark R.</creatorcontrib><creatorcontrib>Erba, Harry P.</creatorcontrib><creatorcontrib>Hurria, Arti</creatorcontrib><creatorcontrib>Weisdorf, Daniel J.</creatorcontrib><creatorcontrib>Artz, Andrew S.</creatorcontrib><title>Allogeneic hematopoietic cell transplantation compared to chemotherapy consolidation in older acute myeloid leukemia (AML) patients 60–75 years in first complete remission (CR1): an alliance (A151509), SWOG, ECOG-ACRIN, and CIBMTR study</title><title>Leukemia</title><addtitle>Leukemia</addtitle><addtitle>Leukemia</addtitle><description>The preferred post-remission therapy for older patients with acute myeloid leukemia (AML) in first complete remission (CR1) remains uncertain. In this retrospective, multicenter study, we compared the outcomes for older AML patients (age 60–77 years) receiving allogeneic hematopoietic cell transplantation (alloHCT) (
n
= 431) with those treated on prospective National Clinical Trials Network induction and nontransplantation chemotherapy (CT) consolidation trials (
n
= 211). AlloHCT patients were younger (median age: 64.2 versus 67.9 years,
p
< 0.001), but more frequently had high-risk AML (high WBC, secondary AML, and unfavorable cytogenetics). Overall survival (OS) was worse in alloHCT during the first 9 months after CR1 (HR = 1.52,
p
= 0.02), but was significantly better thereafter (HR = 0.53,
p
< 0.0001) relative to CT. Treatment-related mortality (TRM) following HCT was worse in the first 9 months (HR = 2.8, 95% CI: 1.5–5.2,
p
= 0.0009), while post-HCT relapse was significantly less frequent beyond 9 months (HR = 0.42, 95% CI: 0.29–0.61,
p
< 0.0001). Despite higher early TRM, alloHCT recipients had superior long-term OS [29% (24–34%) versus CT 13.8% (9–21%) at 5 years]. Although this is a retrospective analysis with potential biases, it indicates that alloHCT led to heightened early risks from TRM, yet reduced relapse and superior long-term survival relative to CT in older AML patients in CR1.</description><subject>631/67/1059/99</subject><subject>631/67/71</subject><subject>96/100</subject><subject>Acute myeloid leukemia</subject><subject>Aged</subject><subject>Antineoplastic Agents - therapeutic use</subject><subject>Cancer</subject><subject>Cancer Research</subject><subject>Chemotherapy</subject><subject>Clinical trials</subject><subject>Consolidation</subject><subject>Critical Care Medicine</subject><subject>Cytogenetics</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Hematology</subject><subject>Hematopoietic Stem Cell Transplantation</subject><subject>Hematopoietic stem cells</subject><subject>Humans</subject><subject>Intensive</subject><subject>Internal Medicine</subject><subject>Leukemia</subject><subject>Leukemia, Myeloid, Acute - drug therapy</subject><subject>Leukemia, Myeloid, Acute - therapy</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Myeloid leukemia</subject><subject>Oncology</subject><subject>Patients</subject><subject>Remission</subject><subject>Remission (Medicine)</subject><subject>Remission Induction</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Stem cell transplantation</subject><subject>Survival</subject><subject>Transplantation</subject><subject>Transplantation, Homologous</subject><subject>Treatment Outcome</subject><subject>United States</subject><issn>0887-6924</issn><issn>1476-5551</issn><issn>1476-5551</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1ks2O0zAUhSMEYoaBB2CDLCGhVmrATuz8zAKpREOp1KFSqcTScpObNoNjB9tB0x3vwBvyADwDzmQYfiRWtnW_c-zre4LgKcEvCY6zV5aSOGUhJnmIaZqG1_eCU0LTJGSMkfvBKc6yNEzyiJ4Ej6y9wngoJg-Dk5jgNCYsPg1-zKXUe1DQlOgArXC60w04fypBSuSMULaTQjnhGq1QqdtOGKiQ06j0vHYHMKI7-oKyWjbViDUKaVmBQaLsHaD2CFI3FZLQf4K2EWgyv1xNUedhUM6iBH__-i1l6AjC2EFcN8a6m8skeL3xImsH40mxIdNzJBQSUjZCleC9CCMM59MZ-vBxvZihi2K9COfFZvl-5sEKFcs3l9sNsq6vjo-DB7WQFp7crmfB9u3FtngXrtaLZTFfhSVLUhcSIUiep4JlaQJ1XmfE_2LOdiwukygBRita1xHdpVlEa1ZmuPQbFmdxlO0EieOz4PVo2_W7FqrSd2mE5J1pWmGOXIuG_11RzYHv9ReeZDTCNPIGk1sDoz_3YB33PzBMRCjQveVRFJMc5wnNPfr8H_RK90b57riHIkZZzrCnXozUXkjgBxDSHfzA-mFcls8T7BkW34BkBEujrTVQ372aYD6kjo-p4z51fEgdv_aaZ3-2e6f4FTMPRCNgfUntwfx-4_9dfwLwheNk</recordid><startdate>20191101</startdate><enddate>20191101</enddate><creator>Ustun, Celalettin</creator><creator>Le-Rademacher, Jennifer</creator><creator>Wang, Hai-Lin</creator><creator>Othus, Megan</creator><creator>Sun, Zhuoxin</creator><creator>Major, Brittny</creator><creator>Zhang, Mei-Jie</creator><creator>Storrick, Elizabeth</creator><creator>Lafky, Jacqueline M.</creator><creator>Chow, Selina</creator><creator>Mrózek, Krzysztof</creator><creator>Attar, Eyal C.</creator><creator>Nand, Such</creator><creator>Bloomfield, Clara D.</creator><creator>Cripe, Larry D.</creator><creator>Tallman, Martin S.</creator><creator>Appelbaum, Frederick</creator><creator>Larson, Richard A.</creator><creator>Marcucci, Guido</creator><creator>Roboz, Gail J.</creator><creator>Uy, Geoffrey L.</creator><creator>Stone, Richard M.</creator><creator>Jatoi, Aminah</creator><creator>Shea, Thomas C.</creator><creator>de Lima, Marcos</creator><creator>Foran, James M.</creator><creator>Sandmaier, Brenda M.</creator><creator>Litzow, Mark R.</creator><creator>Erba, Harry P.</creator><creator>Hurria, Arti</creator><creator>Weisdorf, Daniel J.</creator><creator>Artz, Andrew S.</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><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>3V.</scope><scope>7QL</scope><scope>7RV</scope><scope>7T5</scope><scope>7T7</scope><scope>7TM</scope><scope>7TO</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-2234-7430</orcidid><orcidid>https://orcid.org/0000-0001-6896-6213</orcidid><orcidid>https://orcid.org/0000-0002-8568-4522</orcidid></search><sort><creationdate>20191101</creationdate><title>Allogeneic hematopoietic cell transplantation compared to chemotherapy consolidation in older acute myeloid leukemia (AML) patients 60–75 years in first complete remission (CR1): an alliance (A151509), SWOG, ECOG-ACRIN, and CIBMTR study</title><author>Ustun, Celalettin ; Le-Rademacher, Jennifer ; Wang, Hai-Lin ; Othus, Megan ; Sun, Zhuoxin ; Major, Brittny ; Zhang, Mei-Jie ; Storrick, Elizabeth ; Lafky, Jacqueline M. ; Chow, Selina ; Mrózek, Krzysztof ; Attar, Eyal C. ; Nand, Such ; Bloomfield, Clara D. ; Cripe, Larry D. ; Tallman, Martin S. ; Appelbaum, Frederick ; Larson, Richard A. ; Marcucci, Guido ; Roboz, Gail J. ; Uy, Geoffrey L. ; Stone, Richard M. ; Jatoi, Aminah ; Shea, Thomas C. ; de Lima, Marcos ; Foran, James M. ; Sandmaier, Brenda M. ; Litzow, Mark R. ; Erba, Harry P. ; Hurria, Arti ; Weisdorf, Daniel J. ; Artz, Andrew S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c567t-1aa1997a5876ef9f8169295b53c626e54d4ff24b7824f5c80c824538328ba133</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>631/67/1059/99</topic><topic>631/67/71</topic><topic>96/100</topic><topic>Acute myeloid leukemia</topic><topic>Aged</topic><topic>Antineoplastic Agents - therapeutic use</topic><topic>Cancer</topic><topic>Cancer Research</topic><topic>Chemotherapy</topic><topic>Clinical trials</topic><topic>Consolidation</topic><topic>Critical Care Medicine</topic><topic>Cytogenetics</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Hematology</topic><topic>Hematopoietic Stem Cell Transplantation</topic><topic>Hematopoietic stem cells</topic><topic>Humans</topic><topic>Intensive</topic><topic>Internal Medicine</topic><topic>Leukemia</topic><topic>Leukemia, Myeloid, Acute - drug therapy</topic><topic>Leukemia, Myeloid, Acute - therapy</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Myeloid leukemia</topic><topic>Oncology</topic><topic>Patients</topic><topic>Remission</topic><topic>Remission (Medicine)</topic><topic>Remission Induction</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Stem cell transplantation</topic><topic>Survival</topic><topic>Transplantation</topic><topic>Transplantation, Homologous</topic><topic>Treatment Outcome</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ustun, Celalettin</creatorcontrib><creatorcontrib>Le-Rademacher, Jennifer</creatorcontrib><creatorcontrib>Wang, Hai-Lin</creatorcontrib><creatorcontrib>Othus, Megan</creatorcontrib><creatorcontrib>Sun, Zhuoxin</creatorcontrib><creatorcontrib>Major, Brittny</creatorcontrib><creatorcontrib>Zhang, Mei-Jie</creatorcontrib><creatorcontrib>Storrick, Elizabeth</creatorcontrib><creatorcontrib>Lafky, Jacqueline M.</creatorcontrib><creatorcontrib>Chow, Selina</creatorcontrib><creatorcontrib>Mrózek, Krzysztof</creatorcontrib><creatorcontrib>Attar, Eyal C.</creatorcontrib><creatorcontrib>Nand, Such</creatorcontrib><creatorcontrib>Bloomfield, Clara D.</creatorcontrib><creatorcontrib>Cripe, Larry D.</creatorcontrib><creatorcontrib>Tallman, Martin S.</creatorcontrib><creatorcontrib>Appelbaum, Frederick</creatorcontrib><creatorcontrib>Larson, Richard A.</creatorcontrib><creatorcontrib>Marcucci, Guido</creatorcontrib><creatorcontrib>Roboz, Gail J.</creatorcontrib><creatorcontrib>Uy, Geoffrey L.</creatorcontrib><creatorcontrib>Stone, Richard M.</creatorcontrib><creatorcontrib>Jatoi, Aminah</creatorcontrib><creatorcontrib>Shea, Thomas C.</creatorcontrib><creatorcontrib>de Lima, Marcos</creatorcontrib><creatorcontrib>Foran, James M.</creatorcontrib><creatorcontrib>Sandmaier, Brenda M.</creatorcontrib><creatorcontrib>Litzow, Mark R.</creatorcontrib><creatorcontrib>Erba, Harry P.</creatorcontrib><creatorcontrib>Hurria, Arti</creatorcontrib><creatorcontrib>Weisdorf, Daniel J.</creatorcontrib><creatorcontrib>Artz, Andrew S.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Immunology Abstracts</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Nucleic Acids Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Leukemia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ustun, Celalettin</au><au>Le-Rademacher, Jennifer</au><au>Wang, Hai-Lin</au><au>Othus, Megan</au><au>Sun, Zhuoxin</au><au>Major, Brittny</au><au>Zhang, Mei-Jie</au><au>Storrick, Elizabeth</au><au>Lafky, Jacqueline M.</au><au>Chow, Selina</au><au>Mrózek, Krzysztof</au><au>Attar, Eyal C.</au><au>Nand, Such</au><au>Bloomfield, Clara D.</au><au>Cripe, Larry D.</au><au>Tallman, Martin S.</au><au>Appelbaum, Frederick</au><au>Larson, Richard A.</au><au>Marcucci, Guido</au><au>Roboz, Gail J.</au><au>Uy, Geoffrey L.</au><au>Stone, Richard M.</au><au>Jatoi, Aminah</au><au>Shea, Thomas C.</au><au>de Lima, Marcos</au><au>Foran, James M.</au><au>Sandmaier, Brenda M.</au><au>Litzow, Mark R.</au><au>Erba, Harry P.</au><au>Hurria, Arti</au><au>Weisdorf, Daniel J.</au><au>Artz, Andrew S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Allogeneic hematopoietic cell transplantation compared to chemotherapy consolidation in older acute myeloid leukemia (AML) patients 60–75 years in first complete remission (CR1): an alliance (A151509), SWOG, ECOG-ACRIN, and CIBMTR study</atitle><jtitle>Leukemia</jtitle><stitle>Leukemia</stitle><addtitle>Leukemia</addtitle><date>2019-11-01</date><risdate>2019</risdate><volume>33</volume><issue>11</issue><spage>2599</spage><epage>2609</epage><pages>2599-2609</pages><issn>0887-6924</issn><issn>1476-5551</issn><eissn>1476-5551</eissn><abstract>The preferred post-remission therapy for older patients with acute myeloid leukemia (AML) in first complete remission (CR1) remains uncertain. In this retrospective, multicenter study, we compared the outcomes for older AML patients (age 60–77 years) receiving allogeneic hematopoietic cell transplantation (alloHCT) (
n
= 431) with those treated on prospective National Clinical Trials Network induction and nontransplantation chemotherapy (CT) consolidation trials (
n
= 211). AlloHCT patients were younger (median age: 64.2 versus 67.9 years,
p
< 0.001), but more frequently had high-risk AML (high WBC, secondary AML, and unfavorable cytogenetics). Overall survival (OS) was worse in alloHCT during the first 9 months after CR1 (HR = 1.52,
p
= 0.02), but was significantly better thereafter (HR = 0.53,
p
< 0.0001) relative to CT. Treatment-related mortality (TRM) following HCT was worse in the first 9 months (HR = 2.8, 95% CI: 1.5–5.2,
p
= 0.0009), while post-HCT relapse was significantly less frequent beyond 9 months (HR = 0.42, 95% CI: 0.29–0.61,
p
< 0.0001). Despite higher early TRM, alloHCT recipients had superior long-term OS [29% (24–34%) versus CT 13.8% (9–21%) at 5 years]. Although this is a retrospective analysis with potential biases, it indicates that alloHCT led to heightened early risks from TRM, yet reduced relapse and superior long-term survival relative to CT in older AML patients in CR1.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>31073153</pmid><doi>10.1038/s41375-019-0477-x</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-2234-7430</orcidid><orcidid>https://orcid.org/0000-0001-6896-6213</orcidid><orcidid>https://orcid.org/0000-0002-8568-4522</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0887-6924 |
| ispartof | Leukemia, 2019-11, Vol.33 (11), p.2599-2609 |
| issn | 0887-6924 1476-5551 1476-5551 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6842042 |
| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | 631/67/1059/99 631/67/71 96/100 Acute myeloid leukemia Aged Antineoplastic Agents - therapeutic use Cancer Cancer Research Chemotherapy Clinical trials Consolidation Critical Care Medicine Cytogenetics Disease-Free Survival Female Hematology Hematopoietic Stem Cell Transplantation Hematopoietic stem cells Humans Intensive Internal Medicine Leukemia Leukemia, Myeloid, Acute - drug therapy Leukemia, Myeloid, Acute - therapy Male Medicine Medicine & Public Health Middle Aged Multivariate Analysis Myeloid leukemia Oncology Patients Remission Remission (Medicine) Remission Induction Retrospective Studies Risk Factors Stem cell transplantation Survival Transplantation Transplantation, Homologous Treatment Outcome United States |
| title | Allogeneic hematopoietic cell transplantation compared to chemotherapy consolidation in older acute myeloid leukemia (AML) patients 60–75 years in first complete remission (CR1): an alliance (A151509), SWOG, ECOG-ACRIN, and CIBMTR study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-30T15%3A56%3A02IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Allogeneic%20hematopoietic%20cell%20transplantation%20compared%20to%20chemotherapy%20consolidation%20in%20older%20acute%20myeloid%20leukemia%20(AML)%20patients%2060%E2%80%9375%20years%20in%20first%20complete%20remission%20(CR1):%20an%20alliance%20(A151509),%20SWOG,%20ECOG-ACRIN,%20and%20CIBMTR%20study&rft.jtitle=Leukemia&rft.au=Ustun,%20Celalettin&rft.date=2019-11-01&rft.volume=33&rft.issue=11&rft.spage=2599&rft.epage=2609&rft.pages=2599-2609&rft.issn=0887-6924&rft.eissn=1476-5551&rft_id=info:doi/10.1038/s41375-019-0477-x&rft_dat=%3Cgale_pubme%3EA605035350%3C/gale_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2312545950&rft_id=info:pmid/31073153&rft_galeid=A605035350&rfr_iscdi=true |