Page 270 - Haematologica - Vol. 105 n. 6 - June 2020

K. Halaburda et al.
Figure 2. Leukemia-free survival (LFS), overall survival (OS), and relapse inci- dence (RI) in patients with core-binding factor acute myeloid leukemia in patients without versus with molecular remission pre-transplant. 2-year proba- bility of LFS: 49% (95%CI: 39.8-58.2) vs. 61.6% (95%CI: 56.3-66.9), P=0.046. 2-year probability of OS: 59.9% (95%CI: 50.8-68.9) vs. 65.8% (95%CI: 60.7-71), P=0.47. 2-year risk of relapse: 29.3% (95%CI: 21.2-37.8) vs. 16.2% (95%CI: 12.4-20.4), P=0.003.
Table 3. Mortality during follow up. Causes of death
Number
Total 257
Original disease 83 Infection 62 Graft-versus-host disease 59 Other related to transplantation 21 Interstitial pneumonitis 9 Sinusoidal obstruction syndrome 5 Hemorrhage 4 Second malignancy 4 Cardiac toxicity 2 Missing 8
female versus male donors was associated with increased risk of cGvHD (52.1% vs. 43.4%, P=0.01); the same was true for female to male transplantations versus other com- binations (55.2% vs. 44.5%, P=0.03). Transplantation from CMV positive versus CMV negative donors also cor- related with increased risk of cGvHD (53.2% vs. 40.5%, P=0.002). BM versus PB grafts resulted in lower incidence of cGVHD (37.1% vs. 49.1%, P=0.04). In vivo T-cell deple- tion decreased risk of cGVHD (37.7% vs. 55.9%, P<0.001) (Online Supplementary Table S3). In multivariate analysis, in vivo T-cell depletion was an independent factor for decreased risk of cGvHD (HR=0.56; 95%CI: 0.43-0.72, P<0.001), while PBSCT and CMV donor seropositivity were associated with increased risk of cGVHD (HR=1.72; 95%CI; 1.2-2.46, P=0.003 and HR=1.45; 95%CI: 1.13- 1.87, P=0.004, respectively) (Table 2).
Mortality
During follow up, 257 of 631 patients died. The main causes of death were recurrence of the original disease, infection, and GvHD (Table 3).
Discussion
This retrospective analysis of HSCT in CBF AML in sec- ond hematologic CR was based on a large number of patients reported to the EBMT. Chemotherapy alone after relapse in patients with favorable risk AML is able to pro- duce 5-year survival in 42-44% of patients.16,17 Allogeneic HSCT is recommended by leading organizations in Europe and the USA as consolidation treatment for AML patients achieving CR2.18 In our study, the results of trans- plantation in terms of OS and LFS were a little worse than those described previously for patients with CBF AML transplanted in CR1 and comparable with published out- comes of HSCT performed in CR2.19,20 Similarly to those
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