Allogeneic hematopoietic cell transplant for AML

No impact of pre-transplant extramedullary disease on outcome

S. D. Goyal, M. J. Zhang, H. L. Wang, G. Akpek, E. A. Copelan, C. Freytes, R. P. Gale, M. Hamadani, Y. Inamoto, R. T. Kamble, H. M. Lazarus, D. I. Marks, T. Nishihori, R. F. Olsson, R. Reshef, D. S. Ritchie, W. Saber, B. N. Savani, A. Seber, T. C. Shea & 7 others M. S. Tallman, Baldeep Wirk, D. W. Bunjes, S. M. Devine, M. De Lima, D. J. Weisdorf, G. L. Uy

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

The impact of extramedullary disease (EMD) in AML on the outcomes of allogeneic hematopoietic cell transplantation (alloHCT) is unknown. Using data from the Center for International Blood and Marrow Transplant Research, we compared the outcomes of patients who had EMD of AML at any time before transplant, with a cohort of AML patients without EMD. We reviewed data from 9797 AML patients including 814 with EMD from 310 reporting centers and 44 different countries, who underwent alloHCT between and 1995 and 2010. The primary outcome was overall survival (OS) after alloHCT. Secondary outcomes included leukemia-free survival (LFS), relapse rate and treatment-related mortality (TRM). In a multivariate analysis, the presence of EMD did not affect either OS (hazard ratio 1.00, 95% confidence interval (CI) 0.91-1.09), LFS (0.98, 0.89-1.09), TRM (relative risk 0.92, 95% CI 0.80-1.16, P=0.23) or relapse (relative risk=1.03, 95% CI, 0.92-1.16; P=0.62). Furthermore, the outcome of patients with EMD was not influenced by the location, timing of EMD, or intensity of conditioning regimen. The presence of EMD in AML does not affect transplant outcomes and should not be viewed as an independent adverse prognostic feature.

Original languageEnglish (US)
Pages (from-to)1057-1062
Number of pages6
JournalBone Marrow Transplantation
Volume50
Issue number8
DOIs
StatePublished - Aug 8 2015

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Transplants
Cell Transplantation
Confidence Intervals
Survival
Leukemia
Recurrence
Mortality
Multivariate Analysis
Survival Rate
Bone Marrow
Outcome Assessment (Health Care)
Therapeutics

All Science Journal Classification (ASJC) codes

  • Hematology
  • Transplantation

Cite this

Goyal, S. D., Zhang, M. J., Wang, H. L., Akpek, G., Copelan, E. A., Freytes, C., ... Uy, G. L. (2015). Allogeneic hematopoietic cell transplant for AML: No impact of pre-transplant extramedullary disease on outcome. Bone Marrow Transplantation, 50(8), 1057-1062. https://doi.org/10.1038/bmt.2015.82
Goyal, S. D. ; Zhang, M. J. ; Wang, H. L. ; Akpek, G. ; Copelan, E. A. ; Freytes, C. ; Gale, R. P. ; Hamadani, M. ; Inamoto, Y. ; Kamble, R. T. ; Lazarus, H. M. ; Marks, D. I. ; Nishihori, T. ; Olsson, R. F. ; Reshef, R. ; Ritchie, D. S. ; Saber, W. ; Savani, B. N. ; Seber, A. ; Shea, T. C. ; Tallman, M. S. ; Wirk, Baldeep ; Bunjes, D. W. ; Devine, S. M. ; De Lima, M. ; Weisdorf, D. J. ; Uy, G. L. / Allogeneic hematopoietic cell transplant for AML : No impact of pre-transplant extramedullary disease on outcome. In: Bone Marrow Transplantation. 2015 ; Vol. 50, No. 8. pp. 1057-1062.
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abstract = "The impact of extramedullary disease (EMD) in AML on the outcomes of allogeneic hematopoietic cell transplantation (alloHCT) is unknown. Using data from the Center for International Blood and Marrow Transplant Research, we compared the outcomes of patients who had EMD of AML at any time before transplant, with a cohort of AML patients without EMD. We reviewed data from 9797 AML patients including 814 with EMD from 310 reporting centers and 44 different countries, who underwent alloHCT between and 1995 and 2010. The primary outcome was overall survival (OS) after alloHCT. Secondary outcomes included leukemia-free survival (LFS), relapse rate and treatment-related mortality (TRM). In a multivariate analysis, the presence of EMD did not affect either OS (hazard ratio 1.00, 95{\%} confidence interval (CI) 0.91-1.09), LFS (0.98, 0.89-1.09), TRM (relative risk 0.92, 95{\%} CI 0.80-1.16, P=0.23) or relapse (relative risk=1.03, 95{\%} CI, 0.92-1.16; P=0.62). Furthermore, the outcome of patients with EMD was not influenced by the location, timing of EMD, or intensity of conditioning regimen. The presence of EMD in AML does not affect transplant outcomes and should not be viewed as an independent adverse prognostic feature.",
author = "Goyal, {S. D.} and Zhang, {M. J.} and Wang, {H. L.} and G. Akpek and Copelan, {E. A.} and C. Freytes and Gale, {R. P.} and M. Hamadani and Y. Inamoto and Kamble, {R. T.} and Lazarus, {H. M.} and Marks, {D. I.} and T. Nishihori and Olsson, {R. F.} and R. Reshef and Ritchie, {D. S.} and W. Saber and Savani, {B. N.} and A. Seber and Shea, {T. C.} and Tallman, {M. S.} and Baldeep Wirk and Bunjes, {D. W.} and Devine, {S. M.} and {De Lima}, M. and Weisdorf, {D. J.} and Uy, {G. L.}",
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Goyal, SD, Zhang, MJ, Wang, HL, Akpek, G, Copelan, EA, Freytes, C, Gale, RP, Hamadani, M, Inamoto, Y, Kamble, RT, Lazarus, HM, Marks, DI, Nishihori, T, Olsson, RF, Reshef, R, Ritchie, DS, Saber, W, Savani, BN, Seber, A, Shea, TC, Tallman, MS, Wirk, B, Bunjes, DW, Devine, SM, De Lima, M, Weisdorf, DJ & Uy, GL 2015, 'Allogeneic hematopoietic cell transplant for AML: No impact of pre-transplant extramedullary disease on outcome', Bone Marrow Transplantation, vol. 50, no. 8, pp. 1057-1062. https://doi.org/10.1038/bmt.2015.82

Allogeneic hematopoietic cell transplant for AML : No impact of pre-transplant extramedullary disease on outcome. / Goyal, S. D.; Zhang, M. J.; Wang, H. L.; Akpek, G.; Copelan, E. A.; Freytes, C.; Gale, R. P.; Hamadani, M.; Inamoto, Y.; Kamble, R. T.; Lazarus, H. M.; Marks, D. I.; Nishihori, T.; Olsson, R. F.; Reshef, R.; Ritchie, D. S.; Saber, W.; Savani, B. N.; Seber, A.; Shea, T. C.; Tallman, M. S.; Wirk, Baldeep; Bunjes, D. W.; Devine, S. M.; De Lima, M.; Weisdorf, D. J.; Uy, G. L.

In: Bone Marrow Transplantation, Vol. 50, No. 8, 08.08.2015, p. 1057-1062.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Allogeneic hematopoietic cell transplant for AML

T2 - No impact of pre-transplant extramedullary disease on outcome

AU - Goyal, S. D.

AU - Zhang, M. J.

AU - Wang, H. L.

AU - Akpek, G.

AU - Copelan, E. A.

AU - Freytes, C.

AU - Gale, R. P.

AU - Hamadani, M.

AU - Inamoto, Y.

AU - Kamble, R. T.

AU - Lazarus, H. M.

AU - Marks, D. I.

AU - Nishihori, T.

AU - Olsson, R. F.

AU - Reshef, R.

AU - Ritchie, D. S.

AU - Saber, W.

AU - Savani, B. N.

AU - Seber, A.

AU - Shea, T. C.

AU - Tallman, M. S.

AU - Wirk, Baldeep

AU - Bunjes, D. W.

AU - Devine, S. M.

AU - De Lima, M.

AU - Weisdorf, D. J.

AU - Uy, G. L.

PY - 2015/8/8

Y1 - 2015/8/8

N2 - The impact of extramedullary disease (EMD) in AML on the outcomes of allogeneic hematopoietic cell transplantation (alloHCT) is unknown. Using data from the Center for International Blood and Marrow Transplant Research, we compared the outcomes of patients who had EMD of AML at any time before transplant, with a cohort of AML patients without EMD. We reviewed data from 9797 AML patients including 814 with EMD from 310 reporting centers and 44 different countries, who underwent alloHCT between and 1995 and 2010. The primary outcome was overall survival (OS) after alloHCT. Secondary outcomes included leukemia-free survival (LFS), relapse rate and treatment-related mortality (TRM). In a multivariate analysis, the presence of EMD did not affect either OS (hazard ratio 1.00, 95% confidence interval (CI) 0.91-1.09), LFS (0.98, 0.89-1.09), TRM (relative risk 0.92, 95% CI 0.80-1.16, P=0.23) or relapse (relative risk=1.03, 95% CI, 0.92-1.16; P=0.62). Furthermore, the outcome of patients with EMD was not influenced by the location, timing of EMD, or intensity of conditioning regimen. The presence of EMD in AML does not affect transplant outcomes and should not be viewed as an independent adverse prognostic feature.

AB - The impact of extramedullary disease (EMD) in AML on the outcomes of allogeneic hematopoietic cell transplantation (alloHCT) is unknown. Using data from the Center for International Blood and Marrow Transplant Research, we compared the outcomes of patients who had EMD of AML at any time before transplant, with a cohort of AML patients without EMD. We reviewed data from 9797 AML patients including 814 with EMD from 310 reporting centers and 44 different countries, who underwent alloHCT between and 1995 and 2010. The primary outcome was overall survival (OS) after alloHCT. Secondary outcomes included leukemia-free survival (LFS), relapse rate and treatment-related mortality (TRM). In a multivariate analysis, the presence of EMD did not affect either OS (hazard ratio 1.00, 95% confidence interval (CI) 0.91-1.09), LFS (0.98, 0.89-1.09), TRM (relative risk 0.92, 95% CI 0.80-1.16, P=0.23) or relapse (relative risk=1.03, 95% CI, 0.92-1.16; P=0.62). Furthermore, the outcome of patients with EMD was not influenced by the location, timing of EMD, or intensity of conditioning regimen. The presence of EMD in AML does not affect transplant outcomes and should not be viewed as an independent adverse prognostic feature.

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U2 - 10.1038/bmt.2015.82

DO - 10.1038/bmt.2015.82

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