Browsing by Subject "CYTOGENETICS"

Sort by: Order: Results:

Now showing items 1-2 of 2
  • Schmaelter, Ann-Kristin; Labopin, Myriam; Socie, Gerard; Itälä-Remes, Maija; Blaise, Didier; Yakoub-Agha, Ibrahim; Forcade, Edouard; Cornelissen, Jan; Ganser, Arnold; Beelen, Dietrich; Labussiere-Wallet, Helene; Passweg, Jakob; Savani, Bipin N.; Schmid, Christoph; Nagler, Arnon; Mohty, Mohamad (2020)
    Following chemotherapy, secondary acute myeloid leukemia (sAML), occurring after antecedent hematologic diseases, previous chemotherapy or radiation, has an inferior prognosis compared with de novo AML. To define the outcome of sAML in the context of allogeneic stem cell transplantation (alloSCT), a retrospective, registry-based comparison was performed, including 11,439 patients with de novo and 1325 with sAML. Among transplants in first complete remission (CR1) (n = 8,600), the 3-year cumulative incidence of relapse (RI) and non-relapse mortality (NRM) was 28.5% and 16.4% for de novo, and 35% and 23.4% for sAML. Three-year overall survival (OS), leukemia-free survival (LFS) and Graft-versus-Host Disease/relapse-free survival (GRFS) was 60.8%, 55.1%, and 38.6% for de novo, and 46.7%, 41.6%, and 28.4% for sAML, respectively. In multivariate analysis, sAML was associated with a lower OS (HR = 1.33 [95% CI = 1.21-1.48]; p <10(-5)), LFS (HR = 1.32 [95% CI = 1.19-1.45]; p <10(-5)) and GRFS (HR = 1.2 [95% CI = 1.1-1.31]; p <10(-4)) and higher NRM (HR = 1.37 [95% CI = 1.17-1.59]; p <10(-4)) and RI (HR = 1.27 [95% CI = 1.12-1.44]; p <10(-3)). Results of the Cox model were confirmed in a matched-pair analysis. In contrast, results did not differ between de novo and sAML after alloSCT in induction failure or relapse. Hence, this analysis identified sAML as an independent risk factor for outcome after alloSCT in CR1.
  • Scheid, C.; de Wreede, L.; van Biezen, A.; Koenecke, C.; Gohring, G.; Volin, L.; Maertens, J.; Finke, J.; Passweg, J.; Beelen, D.; Cornelissen, J. J.; Itälä-Remes, M.; Chevallier, P.; Russell, N.; Petersen, E.; Milpied, N.; Espiga, C. Richard; Peniket, A.; Sierra, J.; Mufti, G.; Crawley, C.; Veelken, J. H.; Ljungman, P.; Cahn, J. Y.; Alessandrino, E. P.; de Witte, T.; Robin, M.; Kroeger, N. (2017)
    The International Prognostic Scoring System has been revised (IPSS-R) to predict prognosis of patients with myelodysplastic syndromes at diagnosis. To validate the use of the IPSS-R assessed before transplant rather than at diagnosis we performed a retrospective analysis of the EBMT database. A total of 579 patients had sufficient information available to calculate IPSS-R at transplant. Median overall survival (OS) from transplant was significantly different according to IPSS-R: very low 23.6 months, low 55.0 months, intermediate 19.7 months, high 13.5 months, very high 7.8 months (P <0.001). In a multivariate Cox model the following parameters were significant risk factors for OS: IPSS-R, graft source, age and prior treatment. Median relapse free survival also showed significant differences according to IPSS-R: very low: 23.6 months, low: 24.8 months, intermediate 10.6 months, high 7.9 months, very high 5.5 months (P <0.001). Multivariate risk factors for relapse-free survival (RFS) were: IPSS-R, reduced intensity conditioning, graft source and prior treatment. A trend for an increased relapse incidence was noted for very high risk IPSS-R. We conclude that the IPSS-R at transplant is a useful prognostic score for predicting OS and RFS after transplantation, capturing both disease evolution and response to prior treatment before transplant.