Outcome of HLA-matched related allogeneic hematopoietic stem cell transplantation for patients with acute leukemia in first complete remission treated in Eastern European centers. Better results in recent years

• Published in: Annals of hematology 2009-10, Vol.88 (10), p.1005-1013
• Main Authors: Giebel, Sebastian, Labopin, Myriam, Holowiecki, Jerzy, Labar, Boris, Komarnicki, Mieczyslaw, Koza, Vladimir, Masszi, Tamas, Mistrik, Martin, Lange, Andrzej, Hellmann, Andrzej, Vitek, Antonin, Pretnar, Joze, Mayer, Jiri, Rzepecki, Piotr, Indrak, Karel, Wiktor-Jedrzejczak, Wieslaw, Wojnar, Jerzy, Krawczyk-Kulis, Malgorzata, Kyrcz-Krzemien, Slawomira, Rocha, Vanderson
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Europe, Eastern; Hematology; Hematopoietic Stem Cell Transplantation - methods; Hematopoietic Stem Cell Transplantation - mortality; Histocompatibility; HLA Antigens; Humans; Leukemia - diagnosis; Leukemia - mortality; Leukemia - therapy; Leukemia, Myeloid, Acute - diagnosis; Leukemia, Myeloid, Acute - mortality; Leukemia, Myeloid, Acute - therapy; Medicine; Medicine & Public Health; Middle Aged; Oncology; Original Article; Precursor Cell Lymphoblastic Leukemia-Lymphoma - diagnosis; Precursor Cell Lymphoblastic Leukemia-Lymphoma - mortality; Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy; Prognosis; Recurrence; Remission Induction; Retrospective Studies; Survival Analysis; Time Factors; Transplantation, Homologous; Treatment Outcome; Whole-Body Irradiation; Young Adult
• ISSN: 0939-5555; 1432-0584
• DOI: 10.1007/s00277-009-0719-5

The goal of this study was to analyze results and to determine factors affecting outcome of HLA-matched hematopoetic stem cells transplantation (MRD-HSCT) for patients with acute leukemia transplanted in first complete remission in Eastern European countries. Six hundred forty HSCT were performed between 1990 and 2006 for adults with acute myeloid (n = 459) and lymphoblastic (n = 181) leukemia. Two-year leukemia-free survival (LFS), nonrelapse mortality (NRM), and relapse incidence were 58 ± 2%, 19 ± 2%, and 23 ± 2%, respectively. The cumulative incidence of NRM decreased from 22 ± 2% for patients treated between 1990 and 2002 to 15 ± 3% for transplantations performed between 2003 and 2006 (p = 0.02), despite increasing recipient age. In a multivariate analysis, time of HSCT affected both NRM and LFS. Among other prognostic factors, the use of TBI decreased relapse incidence and increased the LFS rate. We conclude that results of MRD-HSCT for acute leukemia in Eastern Europe improved over time as a consequence of decreased NRM. The use of TBI containing regimens appears advantagous.