Allogeneic Hematopoietic Stem Cell Transplantation Following the Use of Hypomethylating Agents among Patients with Relapsed or Refractory AML: Findings from an International Retrospective Study

Maximilian Stahl, Michelle DeVeaux, Pau Montesinos, Raphaël Itzykson, Ellen K. Ritchie, Mikkael A. Sekeres, Navneet Majhail, John Barnard, Nikolai A. Podoltsev, Andrew M. Brunner, Rami S. Komrokji, Vijaya R Bhatt, Aref Al-Kali, Thomas Cluzeau, Valeria Santini, Gail J. Roboz, Pierre Fenaux, Mark Litzow, Amir T. Fathi, Sarah PerreaultTae Kon Kim, Thomas Prebet, Norbert Vey, Vivek Verma, Guido Kobbe, Juan Bergua, Josefina Serrano, Steven D. Gore, Amer M. Zeidan

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Patients with primary refractory or relapsed acute myeloid leukemia (RR-AML) have very poor prognosis. Due to limited treatment options, some patients are treated with hypomethylating agents (HMAs) due to their tolerability. Little is known about the role of allogeneic hematopoietic stem cell transplantation (HSCT) following HMA therapy in this setting. We retrospectively analyzed an international cohort of 655 RR-AML patients who received HMA therapy to study patterns and outcomes with HSCT. Only 37 patients (5.6%) patients underwent HSCT after HMA therapy. The conditioning regimen was myeloablative in 57% and nonmyeloablative in 43%. Patients received matched unrelated donor, matched sibling, haploidentical and mismatched unrelated HSCT in 56%, 24%, 16% and 4% of cases, respectively. Acute GvHD and chronic GvHD were observed in 40% and 17% of patients. While the median OS for the entire cohort of patients was 15.3 months (95% CI 9.5 – 21.7 months), OS reached 29.7 months (95% CI 7.01 – not-reached) for patients who achieved a complete remission (CR) to HMA and no intervening therapies between HMA therapy and HSCT. Our study suggests that HMA therapy can effectively bridge some patients with RR-AML to HSCT.

Original languageEnglish (US)
Pages (from-to)1754-1758
Number of pages5
JournalBiology of Blood and Marrow Transplantation
Volume24
Issue number8
DOIs
StatePublished - Aug 2018

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Hematopoietic Stem Cell Transplantation
Proxy
Retrospective Studies
Acute Myeloid Leukemia
Therapeutics
Unrelated Donors
Siblings
Outcome Assessment (Health Care)

Keywords

  • AML
  • Hypomethylating agents
  • Survival
  • Transplant

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Allogeneic Hematopoietic Stem Cell Transplantation Following the Use of Hypomethylating Agents among Patients with Relapsed or Refractory AML : Findings from an International Retrospective Study. / Stahl, Maximilian; DeVeaux, Michelle; Montesinos, Pau; Itzykson, Raphaël; Ritchie, Ellen K.; Sekeres, Mikkael A.; Majhail, Navneet; Barnard, John; Podoltsev, Nikolai A.; Brunner, Andrew M.; Komrokji, Rami S.; Bhatt, Vijaya R; Al-Kali, Aref; Cluzeau, Thomas; Santini, Valeria; Roboz, Gail J.; Fenaux, Pierre; Litzow, Mark; Fathi, Amir T.; Perreault, Sarah; Kim, Tae Kon; Prebet, Thomas; Vey, Norbert; Verma, Vivek; Kobbe, Guido; Bergua, Juan; Serrano, Josefina; Gore, Steven D.; Zeidan, Amer M.

In: Biology of Blood and Marrow Transplantation, Vol. 24, No. 8, 08.2018, p. 1754-1758.

Research output: Contribution to journalArticle

Stahl, M, DeVeaux, M, Montesinos, P, Itzykson, R, Ritchie, EK, Sekeres, MA, Majhail, N, Barnard, J, Podoltsev, NA, Brunner, AM, Komrokji, RS, Bhatt, VR, Al-Kali, A, Cluzeau, T, Santini, V, Roboz, GJ, Fenaux, P, Litzow, M, Fathi, AT, Perreault, S, Kim, TK, Prebet, T, Vey, N, Verma, V, Kobbe, G, Bergua, J, Serrano, J, Gore, SD & Zeidan, AM 2018, 'Allogeneic Hematopoietic Stem Cell Transplantation Following the Use of Hypomethylating Agents among Patients with Relapsed or Refractory AML: Findings from an International Retrospective Study', Biology of Blood and Marrow Transplantation, vol. 24, no. 8, pp. 1754-1758. https://doi.org/10.1016/j.bbmt.2018.03.025
Stahl, Maximilian ; DeVeaux, Michelle ; Montesinos, Pau ; Itzykson, Raphaël ; Ritchie, Ellen K. ; Sekeres, Mikkael A. ; Majhail, Navneet ; Barnard, John ; Podoltsev, Nikolai A. ; Brunner, Andrew M. ; Komrokji, Rami S. ; Bhatt, Vijaya R ; Al-Kali, Aref ; Cluzeau, Thomas ; Santini, Valeria ; Roboz, Gail J. ; Fenaux, Pierre ; Litzow, Mark ; Fathi, Amir T. ; Perreault, Sarah ; Kim, Tae Kon ; Prebet, Thomas ; Vey, Norbert ; Verma, Vivek ; Kobbe, Guido ; Bergua, Juan ; Serrano, Josefina ; Gore, Steven D. ; Zeidan, Amer M. / Allogeneic Hematopoietic Stem Cell Transplantation Following the Use of Hypomethylating Agents among Patients with Relapsed or Refractory AML : Findings from an International Retrospective Study. In: Biology of Blood and Marrow Transplantation. 2018 ; Vol. 24, No. 8. pp. 1754-1758.
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T1 - Allogeneic Hematopoietic Stem Cell Transplantation Following the Use of Hypomethylating Agents among Patients with Relapsed or Refractory AML

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AU - Stahl, Maximilian

AU - DeVeaux, Michelle

AU - Montesinos, Pau

AU - Itzykson, Raphaël

AU - Ritchie, Ellen K.

AU - Sekeres, Mikkael A.

AU - Majhail, Navneet

AU - Barnard, John

AU - Podoltsev, Nikolai A.

AU - Brunner, Andrew M.

AU - Komrokji, Rami S.

AU - Bhatt, Vijaya R

AU - Al-Kali, Aref

AU - Cluzeau, Thomas

AU - Santini, Valeria

AU - Roboz, Gail J.

AU - Fenaux, Pierre

AU - Litzow, Mark

AU - Fathi, Amir T.

AU - Perreault, Sarah

AU - Kim, Tae Kon

AU - Prebet, Thomas

AU - Vey, Norbert

AU - Verma, Vivek

AU - Kobbe, Guido

AU - Bergua, Juan

AU - Serrano, Josefina

AU - Gore, Steven D.

AU - Zeidan, Amer M.

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N2 - Patients with primary refractory or relapsed acute myeloid leukemia (RR-AML) have very poor prognosis. Due to limited treatment options, some patients are treated with hypomethylating agents (HMAs) due to their tolerability. Little is known about the role of allogeneic hematopoietic stem cell transplantation (HSCT) following HMA therapy in this setting. We retrospectively analyzed an international cohort of 655 RR-AML patients who received HMA therapy to study patterns and outcomes with HSCT. Only 37 patients (5.6%) patients underwent HSCT after HMA therapy. The conditioning regimen was myeloablative in 57% and nonmyeloablative in 43%. Patients received matched unrelated donor, matched sibling, haploidentical and mismatched unrelated HSCT in 56%, 24%, 16% and 4% of cases, respectively. Acute GvHD and chronic GvHD were observed in 40% and 17% of patients. While the median OS for the entire cohort of patients was 15.3 months (95% CI 9.5 – 21.7 months), OS reached 29.7 months (95% CI 7.01 – not-reached) for patients who achieved a complete remission (CR) to HMA and no intervening therapies between HMA therapy and HSCT. Our study suggests that HMA therapy can effectively bridge some patients with RR-AML to HSCT.

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