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Bone Marrow Transplant. 2015 Mar;50(3):341-7. doi: 10.1038/bmt.2014.262. Epub 2014 Nov 17.

High numbers of mobilized CD34+ cells collected in AML in first remission are associated with high relapse risk irrespective of treatment with autologous peripheral blood SCT or autologous BMT.

Author information

1
Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
2
EORTC Headquarters, Brussels, Belgium.
3
CHU, Lyon, France.
4
Hôtel-Dieu, Paris, France.
5
Necker-Institut Curie, Paris, France.
6
Sapienza University, Roma, Italy.
7
Federico II University, Napoli, Italy.
8
Tor Vergata University Hospital, Roma, Italy.
9
Ospedale Civile, Pescara, Italy.
10
University Hospital Rebro, Zagreb, Croatia.
11
CHU Sart-Tilman, Liège, Belgium.
12
Institute Hematology, Prague, Czech Republic.
13
Gustave Roussy Comprehensive Cancer Center, Villejuif, France.
14
A.O.R.N. San Giuseppe Moscati, Avelino, Italy.
15
GIMEMA Data Center, Roma, Italy.
16
Universitair Ziekenhuis Gasthuisberg, Leuven, Belgium.
17
Leiden University Medical Center, Leiden, The Netherlands.

Abstract

The faster hematopoietic recovery after autologous peripheral blood SCT (APBSCT) in patients with AML may be offset by an increased relapse risk as compared with autologous BMT (ABMT). The EORTC and GIMEMA Leukemia Groups conducted a trial (AML-10) in which they compared, as second randomization, APBSCT and ABMT in first CR patients without an HLA compatible donor. A total of 292 patients were randomized. The 5-year DFS rate was 41% in the APBSCT arm and 46% in the ABMT arm with a hazard ratio (HR) of 1.17; 95% confidence interval=0.85-1.59; P=0.34. The 5-year cumulative relapse incidence was 56% vs 49% (P=0.26), and the 5-year OS 50% and 55% (P=0.6) in the APBSCT and ABMT groups, respectively. APBSCT was associated with significantly faster recovery of neutrophils and platelets, shorter duration of hospitalization, reduced need of transfusion packed RBC and less days of intravenous antibiotics. In both treatment groups, higher numbers of mobilized CD34+ cells were associated with a significantly higher relapse risk irrespective of the treatment given after the mobilization. Randomization between APBSCT and ABMT did not result in significantly different outcomes in terms of DFS, OS and relapse incidence.

PMID:
25402418
DOI:
10.1038/bmt.2014.262
[Indexed for MEDLINE]
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