Hematopoietic stem cell transplantation for adults with relapsed acute promyelocytic leukemia in second complete remission

Jaime Sanz*, Myriam Labopin, Miguel A. Sanz, Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation (EBMT), Mahmoud Aljurf, Aida Botelho Sousa, Charles Craddock, Tsila Zuckerman, Hélène Labussière-Wallet, Antonio Campos, Giovanni Grillo, Zubeyde Nur Ozkurt, J. J. Cornelissen, Péter Reményi, Massimo Martino, Rocio Parody Porras, Arnon Nagler, Norbert Claude Gorin, Mohamad Mohty

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

18 Citations (Scopus)
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Abstract

We retrospectively compared outcomes of a large series of adult patients with APL in CR2 receiving alloHSCT (n = 228) or autoHSCT (n = 341) reported to the European Society for Blood and Marrow Transplantation from January 2004 to December 2018. The 2-year cumulative incidence of non-relapse mortality was significantly higher for alloHSCT 17.3% (95% CI 12.5–22.8) compared with autoHSCT 2.7% (95% CI 1.2–5) (p = 0.001), while differences in relapse rate were not significant (28% versus 22.9%; p = 0.28). Leukemia-free survival (LFS) and overall survival (OS) favored autoHSCT with 74.5% (95% CI 69–79.2) and 82.4% (95% CI 77.3–86.5) compared with alloHSCT with 54.7% (95% CI 47.5–61.3) (p = 0.001) and 64.3% (95% CI 57.2–70.6), respectively (p = 0.001 and p = 0.001). Multivariable analysis showed significantly worse LFS after alloHSCT (HR 0.49; 95% CI 0.37–0.67; p < 0.0001), older age (p = 0.001), and shorter time from diagnosis to transplant (p = 0.00015). Similar results were obtained for OS. The study shows that autoHSCT resulted in better survival outcomes (LFS and OS) for APL in CR2. These results were mainly due to reduced NRM in the autoHSCT as compared to alloHSCT.

Original languageEnglish
Pages (from-to)1272-1280
Number of pages9
JournalBone Marrow Transplantation
Volume56
Issue number6
Early online date15 Dec 2020
DOIs
Publication statusPublished - Jun 2021

Bibliographical note

Publisher Copyright:
© 2020, The Author(s), under exclusive licence to Springer Nature Limited.

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