A1 Refereed original research article in a scientific journal
Reduced Intensity transplantation vs chemotherapy in CR1. A prospective, pseudorandomized study in 50-70 year old AML patients
Authors: Brune, Mats; Kiss, Thomas; Anderson, Harald; Nicklasson, Malin; Delage, Robert; Finke, Jürgen; Gedde-Dahl, Tobias; Hébert, Josée; Höglund, Martin; Kaare, Ain; Lazarevic, Vladimir; Möllgård, Lars; Remes, Kari; Ritchie, David; Spyridonidis, Alexandros; Sabloff, Mitchell; Spearing, Ruth; Wallhult, Elisabeth; Ljungman, Per
Publisher: SPRINGERNATURE
Publishing place: LONDON
Publication year: 2024
Journal: Bone Marrow Transplantation
Journal name in source: BONE MARROW TRANSPLANTATION
Journal acronym: BONE MARROW TRANSPL
Volume: 59
Issue: 12
First page : 1676
Last page: 1682
Number of pages: 7
ISSN: 0268-3369
eISSN: 1476-5365
DOI: https://doi.org/10.1038/s41409-024-02408-x
Web address : https://doi.org/10.1038/s41409-024-02408-x
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/457857430
The aim of this prospective, international multicenter, pseudorandomized study comparing RICT HCT to standard-of-care chemotherapy in intermediate- or high-risk AML patients 50-70 years using the donor versus no-donor concept. Part 1 included only patients with potential family donors (RD) at the date of HLA-typing of the first potential sibling or CR-date, if later. Part 2 allowed the inclusion of patients without a possible sibling donor using the start of an unrelated donor (URD) search as inclusion date. 360 patients were registered and 309 analyzed. The median follow-up was 47 months (1-168). There was no difference in overall survival (OS) between the RD (n = 124) and the Control (n = 77) groups (p = 0.50, 3-year OS RD: 0.41(95% CI; 0.32-0.50); Controls: 0.49 (95% CI; 0.37-0.59)). The main cause of death was relapse (67% RD; 88% Controls). In Part 2, the 3-year OS was 0.60 (95% CI 0.50-0.70) for URD-HCT (n = 86) and 0.37 (95% CI 0.13-0.62) for Controls (n = 20), respectively (p = 0.10). When analyzing transplanted patients (Part 2), the OS at 3-years was higher for URD-HCT than RD-HCT (0.67 (0.55-0.76) vs. 0.42 (0.26-0.57; p = 0.005). This study doesn't support elderly HLA-identical siblings as donors for older AML patients undergoing a RICT allogeneic HCT in first CR.
Downloadable publication This is an electronic reprint of the original article. |  |
Funding information in the publication:
Inger Andersson and Joanne Blais for their work for the study. Economic support was granted by the Swedish Research Council (2012-38102-91941-45), the Swedish Cancer Foundation, CA 2017/364, 2017/369, the Swedish State under the ALF agreement, Lion´s Cancer Research Fund of Western Sweden, and NordForsk Project No. 71306. The study was supported by Cell Therapy Transplant Canada (formerly named Canadian Blood and Marrow Transplant Group), and Otsuka pharmaceuticals (Canada).Open access funding provided by Karolinska Institute.
