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

Sebastian Giebel (1) , Myriam Labopin (2) , Jerzy Holowiecki (1) , Boris Labar (3) , Mieczyslaw Komarnicki (4) , Vladimir Koza (5) , Tamas Masszi (6) , Martin Mistrik (7) , Andrzej Lange (8) , Andrzej Hellmann (9) , Antonin Vitek (10) , Joze Pretnar (11) , Jiri Mayer (12) , Piotr Rzepecki (13) , Karel Indrak (14) , Wieslaw Wiktor-Jedrzejczak (15) , Jerzy Wojnar (16) , Malgorzata Krawczyk-Kulis (16) , Slawomira Kyrcz-Krzemien (16) , Vanderson Rocha

1 Department of Clinical Oncology, Comprehensive Cancer Center
2 UPMC - Université Pierre et Marie Curie - Paris 6
3 Department of Hematology
4 Department of Hematology
5 Department of Hematology and Oncology
6 Department of Bone Marrow Transplantation
7 Clinic of Hematology and Transfusion Medicine
8 Lower Silesian Center for Cellular Transplantation with National Bone Marrow Donor Registry
9 Department of Hematology
10 Institute of Hematology and Blood Transfusion
11 Department of Hematology
12 Department of Internal Medicine, Hemato-Oncology
13 Bone Marrow Transplantation Unit
14 Department of Hemato-Oncology
15 Department of Hematology and Oncology
16 Department of Hematology and Bone Marrow Transplantation

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 ( = 459) and lymphoblastic ( = 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 ( = 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.

Mots clés: Prognostic factors; Leukemia-free survival; Nonrelapse mortality; Matched related donor HSCT; Acute leukemia

Sebastian Giebel, Myriam Labopin, Jerzy Holowiecki, Boris Labar, Mieczyslaw Komarnicki, et al.. 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. Annals of Hematology, 2009, 88 (10), pp.1005-1013. ⟨10.1007/s00277-009-0719-5⟩. ⟨hal-00535042⟩