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Reduced Intensity transplantation vs chemotherapy in CR1. A prospective, pseudorandomized study in 50–70 year old AML patients

Brune, Mats ; Kiss, Thomas ; Anderson, Harald LU ; Nicklasson, Malin ; Delage, Robert ; Finke, Jürgen ; Gedde-Dahl, Tobias ; Hébert, Josée ; Höglund, Martin and Kaare, Ain , et al. (2024) In Bone Marrow Transplantation p.1-7
Abstract

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%... (More)

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.

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organization
publishing date
type
Contribution to journal
publication status
epub
subject
in
Bone Marrow Transplantation
pages
1 - 7
publisher
Nature Publishing Group
external identifiers
  • pmid:39223244
  • scopus:85202916350
ISSN
0268-3369
DOI
10.1038/s41409-024-02408-x
language
English
LU publication?
yes
additional info
Publisher Copyright: © The Author(s) 2024.
id
e3619b9f-b595-494e-8143-0fff13918356
date added to LUP
2024-09-11 16:24:20
date last changed
2024-09-13 03:06:10
@article{e3619b9f-b595-494e-8143-0fff13918356,
  abstract     = {{<p>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.</p>}},
  author       = {{Brune, Mats and Kiss, Thomas and Anderson, Harald and Nicklasson, Malin and Delage, Robert and Finke, Jürgen and Gedde-Dahl, Tobias and Hébert, Josée and Höglund, Martin and Kaare, Ain and Lazarevic, Vladimir and Möllgård, Lars and Remes, Kari and Ritchie, David and Spyridonidis, Alexandros and Sabloff, Mitchell and Spearing, Ruth and Wallhult, Elisabeth and Ljungman, Per}},
  issn         = {{0268-3369}},
  language     = {{eng}},
  pages        = {{1--7}},
  publisher    = {{Nature Publishing Group}},
  series       = {{Bone Marrow Transplantation}},
  title        = {{Reduced Intensity transplantation vs chemotherapy in CR1. A prospective, pseudorandomized study in 50–70 year old AML patients}},
  url          = {{http://dx.doi.org/10.1038/s41409-024-02408-x}},
  doi          = {{10.1038/s41409-024-02408-x}},
  year         = {{2024}},
}