Factors affecting long‐term outcome after allogeneic haematopoietic stem cell transplantation for acute myelogenous leukaemia: a retrospective study of 172 adult patients reported to the Austrian Stem Cell Transplantation Registry

• Published in: British journal of haematology 2002-06, Vol.117 (4), p.914-923
• Main Authors: Greinix, Hildegard T., Nachbaur, David, Krieger, Otto, Eibl, Margit, Knöbl, Paul, Kalhs, Peter, Lutz, Dieter, Linkesch, Werner, Niederwieser, Dietger, Hinterberger, Wolfgang, Lechner, Klaus, Rosenmayr, Agathe, Gritsch, Beate
• Format: Article
• Language: English
• Subjects: acute myelogenous leukaemia; Adult; Age Factors; allogeneic stem cell transplantation; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Bone marrow, stem cells transplantation. Graft versus host reaction; Cyclosporine - therapeutic use; Female; Graft vs Host Disease - prevention & control; Hematologic and hematopoietic diseases; Hematopoietic Stem Cell Transplantation - mortality; Humans; Leukemia, Myeloid, Acute - mortality; Leukemia, Myeloid, Acute - surgery; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Male; Medical sciences; Methotrexate - therapeutic use; Methylprednisolone - therapeutic use; Middle Aged; Multivariate Analysis; Registries; Retrospective Studies; Risk Factors; Survival Rate; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Transplantation Conditioning; Transplantation, Homologous; Treatment Outcome; Whole-Body Irradiation
• ISSN: 0007-1048; 1365-2141
• DOI: 10.1046/j.1365-2141.2002.03532.x

Between 1982 and 2000, 172 patients with acute myelogenous leukaemia (AML) received haematopoietic stem cell transplants (SCT) from related (n = 132) or unrelated (n = 40) donors at four Austrian transplant centres and their results were reported to the Austrian Stem Cell Transplantation Registry. Conditioning for SCT consisted of cyclophosphamide and total body irradiation in 156 (91%) patients. Graft‐versus‐host disease (GVHD) prophylaxis was with standard cyclosporine and methotrexate in 95 (55%) patients. Median post‐transplant follow‐up was 5·6 years (range, 0·2‐‐16·7). Multivariate analysis of transplant‐related mortality (TRM) identified four variables associated with a lower risk: disease status of first complete remission (CR) at SCT, patient age of 45 years and younger, transplant performed during or after 1995, and lack of acute GVHD. Variables associated with significantly improved leukaemia‐free survival were: bone marrow as the stem cell source, disease status of first CR at SCT, and occurrence of chronic GVHD. In multivariate analysis, transplantation performed during or after 1995, first CR at SCT, occurrence of limited chronic GVHD and lack of acute GVHD grades III to IV were associated with increased overall survival. Based on these analyses, options for the improvement of results obtained with allogeneic SCT in patients with AML could be defined.