In patients older than 55 years with AML in first CR, should we search for a matched unrelated donor when an old sibling donor is available?

Date publication

septembre 2015

Auteurs

Membres identifiés du Cancéropôle Est :
Dr LIOURE Bruno

Tous les auteurs :
Peffault de Latour R, Labopin M, Cornelissen J, Vigouroux S, Craddock C, Blaise D, Huyn A, Vindelov L, Maertens J, Chevallier P, Fegueux N, Socie G, Cahn JY, Petersen E, Schouten H, Lioure B, Russell N, Corral LL, Ciceri F, Nagler A, Mohty M

Lien Pubmed

https://www.ncbi.nlm.nih.gov/pubmed/26367237

Résumé

Allogeneic hematopoietic transplantation is increasingly used in patients aged 55 years or more with AML. The question of whether outcomes can be improved with an allele-level 8/8 HLA-matched unrelated donor (MUD) rather than an older HLA-matched sibling (MSD, more than 55 years) is still unanswered. We thus analyzed outcomes in 714 patients aged 55 years and older with AML in first CR (CR1) who received PBSCs after a reduced-intensity conditioning hematopoietic cell transplant from a MUD (n=310) or a MSD (n=404) in a recent period (2005-2010). The 3-year cumulative incidences (CIs) of non-relapse mortality were 17% and 23% with MSD and MUD, respectively (P=0.17). The 3-year CIs of relapse were 37% and 30%, respectively (P=0.12), resulting in a 3-year CI of leukemia-free survival of 46% and 47%, respectively (P=0.51). The 3-year overall survival was 49% with both MSD and MUD. In conclusion, HLA-identical sibling donors aged 55 years or more should not be excluded because of age for patients aged 55 years and older with AML in CR1.Bone Marrow Transplantation advance online publication, 14 September 2015; doi:10.1038/bmt.2015.180.

Référence

Bone Marrow Transplant. 2015 Sep 14