Autologous stem cell transplantation for adult acute leukemia in 2015: time to rethink? Present status and future prospects

Gorin, Norbert‐Claude; Giebel, Sebastian; Labopin, Myriam; Savani, Bipin N.; Mohty, Mohamad; Nagler, Arnon

doi:10.1038/bmt.2015.179

Cited by 49 publications

(48 citation statements)

References 79 publications

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“…167,178 Myeloablative conditioning vs RIC. RIC potentially extends the curative graft-versus-leukemia effect to patients of older age or to young patients with significant comorbidities.…”

Section: -5977174177mentioning

confidence: 99%

Diagnosis and management of AML in adults: 2017 ELN recommendations from an international expert panel

Döhner

Estey

Grimwade

et al. 2017

Blood

4,691

5,387

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The first edition of the European LeukemiaNet (ELN) recommendations for diagnosis and management of acute myeloid leukemia (AML) in adults, published in 2010, has found broad acceptance by physicians and investigators caring for patients with AML. Recent advances, for example, in the discovery of the genomic landscape of the disease, in the development of assays for genetic testing and for detecting minimal residual disease (MRD), as well as in the development of novel antileukemic agents, prompted an international panel to provide updated evidence- and expert opinion-based recommendations. The recommendations include a revised version of the ELN genetic categories, a proposal for a response category based on MRD status, and criteria for progressive disease

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“…167,178 Myeloablative conditioning vs RIC. RIC potentially extends the curative graft-versus-leukemia effect to patients of older age or to young patients with significant comorbidities.…”

Section: -5977174177mentioning

confidence: 99%

Diagnosis and management of AML in adults: 2017 ELN recommendations from an international expert panel

Döhner

Estey

Grimwade

et al. 2017

Blood

4,691

5,387

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“…Nevertheless, auto-HSCT holds several advantages including low non-relapse mortality rates, absence of graft-vs-host disease (GVHD) risk, lower incidence of late effects, and better quality of life for survivors compared to allo-HSCT; concerns include high relapse rate, due to the absence of graft-vs-leukemia (GVL) effect and the theoretic possibility of graft contamination by leukemic cells [6]. …”

Section: Introductionmentioning

confidence: 99%

Matched and mismatched unrelated donor compared to autologous stem cell transplantation for acute myeloid leukemia in first complete remission: a retrospective, propensity score-weighted analysis from the ALWP of the EBMT

Saraceni

Labopin²,

Gorin³

et al. 2016

J Hematol Oncol

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BackgroundOptimal post-remission strategy for patients with acute myeloid leukemia (AML) is matter of intense debate. Recent reports have shown stronger anti-leukemic activity but similar survival for allogeneic stem cell transplantation (allo-HSCT) from matched sibling donor compared to autologous transplantation (auto-HSCT); however, there is scarcity of literature confronting auto-HSCT with allo-HSCT from unrelated donor (UD-HSCT), especially mismatched UD-HSCT.MethodsWe retrospectively compared outcome of allogeneic transplantation from matched (10/10 UD-HSCT) or mismatched at a single HLA-locus unrelated donor (9/10 UD-HSCT) to autologous transplantation in patients with AML in first complete remission (CR1). A total of 2879 patients were included; 1202 patients received auto-HSCT, 1302 10/10 UD-HSCT, and 375 9/10 UD-HSCT. A propensity score-weighted analysis was conducted to control for disease risk imbalances between the groups.ResultsMatched 10/10 UD-HSCT was associated with the best leukemia-free survival (10/10 UD-HSCT vs auto-HSCT: HR 0.7, p = 0.0016). Leukemia-free survival was not statistically different between auto-HSCT and 9/10 UD-HSCT (9/10 UD-HSCT vs auto-HSCT: HR 0.8, p = 0.2). Overall survival was similar across the groups (10/10 UD-HSCT vs auto-HSCT: HR 0.98, p = 0.84; 9/10 UD-HSCT vs auto-HSCT: HR 1.1, p = 0.49). Notably, in intermediate-risk patients, OS was significantly worse for 9/10 UD-HSCT (9/10 UD-HSCT vs auto-HSCT: HR 1.6, p = 0.049), while it did not differ between auto-HSCT and 10/10 UD-HSCT (HR 0.95, p = 0.88). In favorable risk patients, auto-HSCT resulted in 3-year LFS and OS rates of 59 and 78 %, respectively.ConclusionsOur findings suggest that in AML patients in CR1 lacking an HLA-matched sibling donor, 10/10 UD-HSCT significantly improves LFS, but this advantage does not translate in better OS compared to auto-HSCT. In intermediate-risk patients lacking a fully HLA-matched donor, auto-HSCT should be considered as a valid option, as better survival appears to be provided by auto-HSCT compared to mismatched UD-HSCT. Finally, auto-HSCT provided an encouraging outcome in patients with favorable risk AML.Electronic supplementary materialThe online version of this article (doi:10.1186/s13045-016-0314-x) contains supplementary material, which is available to authorized users.

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“…Consequently, they are offered consolidation treatment in CR1 with either conventional chemotherapy, autologous or allogeneic transplantation [2][3][4]. Among these options, high-dose chemotherapy (HDCT) with autologous stem cell transplantation (ASCT) can be applied to consolidate CR1 in AML patients who have favorable or intermediate risk cytogenetic and molecular abnormalities [5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Revisiting G-CSF Support for Hematologic Recovery after Autologous Transplantation in AML Patients

Oberson¹,

Novak²,

Taleghani³

et al. 2017

Ann Hematol Oncol

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Autologous stem cell transplantation for adult acute leukemia in 2015: time to rethink? Present status and future prospects

Cited by 49 publications

References 79 publications

Diagnosis and management of AML in adults: 2017 ELN recommendations from an international expert panel

Diagnosis and management of AML in adults: 2017 ELN recommendations from an international expert panel

Matched and mismatched unrelated donor compared to autologous stem cell transplantation for acute myeloid leukemia in first complete remission: a retrospective, propensity score-weighted analysis from the ALWP of the EBMT

Revisiting G-CSF Support for Hematologic Recovery after Autologous Transplantation in AML Patients

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