Yazarlar : Devillier R, Crocchiolo R, Etienne A, Prebet T, Charbonnier A, Fürst S, El-Cheikh J, D'Incan E, Rey J, Faucher C, Blaise D, Vey N.

Yayın : Leuk Lymphoma.

Yayın Yılı : 2012

Pubmed Linki : http://www.ncbi.nlm.nih.gov/pubmed/23082952

Konu : Kemik İliği Nakli

Literatür İçeriği :  Abstract Although allogeneic-stem-cell transplantation (Allo-SCT) is an effective treatment for high risk acute myeloid leukemia (AML), relapses remain a major cause of treatment failure. There is currently no standard of care for post-transplant relapse of AML but the increasing numbers of investigational agent in this setting require a better knowledge of their outcome. We retrospectively evaluated the efficacy of salvage therapies in 54 patients with AML relapsing after Allo-SCT. Twenty-four patients received intensive salvage treatment (17 non-intensive chemotherapy, 13 supportive care). CRs were seen only in the group who received intensive salvage (CR rate: 17/24 (71%)). One-year overall survival was 19% (median: 3.4 months) in the whole study group and 33% in the intensive savage group (versus 7% for patients without intensive salvage, p=0.004). Factors influencing OS were, time to relapse after Allo-SCT (HR: 3.7 [1.6-8.8]) and Performance Status (PS) at relapse (HR: 2.2 [1.1-4.4]) by multivariate analysis. Our results confirm the poor prognosis of AML relapse after Allo-SCT. In selected patients, salvage chemotherapy produces CR but these are short lived. Other strategies aiming at modulating immune anti-leukemic activity have to be developed.

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