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Allogeneic hematopoietic cell transplant for AML: no impact of pre-transplant extramedullary disease on outcome
St Louis Univ, Med Ctr, St Louis, MO USA..
Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA.;Med Coll Wisconsin, Div Biostat, Inst Hlth & Soc, Milwaukee, WI 53226 USA..
Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA..
Banner MD Anderson Canc Ctr, Hematol Oncol Sect, Gilbert, AZ USA..
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2015 (English)In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 50, no 8, 1057-1062 p.Article in journal (Refereed) Published
Abstract [en]

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 (Cl) 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.

Place, publisher, year, edition, pages
2015. Vol. 50, no 8, 1057-1062 p.
National Category
Cancer and Oncology
URN: urn:nbn:se:uu:diva-264321DOI: 10.1038/bmt.2015.82ISI: 000361164200005PubMedID: 25915806OAI: oai:DiVA.org:uu-264321DiVA: diva2:861139
Available from: 2015-10-15 Created: 2015-10-09 Last updated: 2015-10-15Bibliographically approved

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