The clinical outcome of primary refractory (PRF) AML patients is poor and only a minor proportion of patients is rescued by allogenic hematopoietic stem cell transplantation (HSCT). The identification of pre-HSCT variables may help to determine PRF AML patients who can most likely benefit from HSCT. We analyzed PRF AML patients transplanted between 1999 and 2012 from a sibling, unrelated donor or a cord blood unit. Overall, 227 patients from 26 Gruppo Italiano Trapianto di Midollo Osseo e Terapia cellulare centers were included in the analysis. At 3 years, the overall survival was 14%. By multivariate analysis, the number of chemotherapy cycles, (hazard ratio (HR): 1.87; 95% confidence interval (CI): 1.24–2.85; P=0.0028), the percentage of bone marrow or peripheral blood blasts (HR: 1.75; 95% CI: 1.16–2.64; P=0.0078), the adverse cytogenetic (HR: 1.44; 95% CI: 1.00–2.07; P=0.0508) and the age of patients (HR: 1.77; 95% CI: 1.08–2.88; P=0.0223) remained significantly associated with survival. Thus, we set up a new score predicting at 3 years after transplantation, an overall survival probability of 32% for patients with score 0 (no or 1 prognostic factor), 10% for patients with score 1 (2 prognostic factors) and 3% for patients with score 2 (3 or 4 prognostic factors).Bone Marrow Transplantation advance online publication, 9 January 2017; doi:10.1038/bmt.2016.325.
Factors predicting outcome after allogeneic transplant in refractory acute myeloid leukemia: a retrospective analysis of Gruppo Italiano Trapianto di Midollo Osseo (GITMO) / E. Todisco, F. Ciceri, C. Boschini, F. Giglio, A. Bacigalupo, F. Patriarca, I. Donnini, E.P. Alessandrino, W. Arcese, A.P. Iori, P. Marenco, I. Cavattoni, P. Chiusolo, E. Terruzzi, L. Castagna, A. Santoro, A. Bosi, E. Oldani, B. Bruno, F. Bonifazi, A. Rambaldi. - In: BONE MARROW TRANSPLANTATION. - ISSN 0268-3369. - (2017).
|Titolo:||Factors predicting outcome after allogeneic transplant in refractory acute myeloid leukemia: a retrospective analysis of Gruppo Italiano Trapianto di Midollo Osseo (GITMO)|
RAMBALDI, ALESSANDRO (Corresponding)
|Parole Chiave:||Hematology; Transplantation|
|Settore Scientifico Disciplinare:||Settore MED/15 - Malattie del Sangue|
|Data di pubblicazione:||2017|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1038/bmt.2016.325|
|Appare nelle tipologie:||01 - Articolo su periodico|