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• W2071985892 abstract "Background: AML patients who receive allogeneic hematopoietic stem cell transplantation for residual or refractory disease have poor outcome. Only 10–15% of these patients are long-term survivors. Predictors of long-term survival in these patients remain undefined. Method: In a retrospective analysis (between 1982-September 2004) we evaluated percentage of marrow blasts at the time of transplantation and disease-free (DFS)/overall survival (OS) in AML patients. Residual bone marrow disease was stratified in to 3 groups (group I: ≥5–9.9% blasts, group II: >10–19.9% blast and group III: ≥20% blast). We also analyzed other variables known to affect outcome of AML and allogeneic transplantation including age, cytogenetics, secondary AML (including prior MDS), extramedullary disease, matched related/unrelated donor, graft-versus host disease and performance status. Results: 37/112 (33%) AML pts received allogeneic transplantation for persistent leukemia. Of these, 5/37 (13.5%) pts were in group I, 7/37 (18.9%) were in group II and 25/37 (67.6%) patients had more than 20% blasts (group III). All 25 patients with marrow blast of >20% died at median of 4 month from the date of transplant (Progressive disease= 18, Non relapse mortality= 7). Of the 7 patients with blast count of >10–19.9%, 4 are alive without disease at median of 23 months (range 12–41 months); 3 patients died at median of 10 months (Progressive disease =2, Non relapse mortality= 1). One out of 5 patients with marrow blast count of 5–9.9% is alive at median of 15 months; 4 patients died at median of 2 months (Progressive disease= 2, Non relapse mortality= 2). Five of 37 (13.5%) patients are long-term survivors. Their characteristics include (Age= 31, 43, 44, 58, 62, MRD transplant= 4, MUD= 1, non-myeloablative transplant= 1, DLI= 2, Grade III aGVHD= 3, Grade II aGVHD= 2, limited cGVHD= 5, myelodysplasia= 1, extramedullary disease= 1, poor risk cytogenetics= 0). Conclusion: Although a threshold number of blast as a predictor of successful transplant is not defined, patients with more than 20% blast at the time of transplant had uniformly poor outcome. All 5 survivors had acute graft versus host disease and 4 have limited mild cGVHD. None of the survivors had poor risk cytogenetics; no other patient or treatment characteristics predicted survivor." @default.
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• W2071985892 date "2005-02-01" @default.
• W2071985892 modified "2023-09-23" @default.
• W2071985892 title "Residual AML at the time of allograft: Outcome analysis based on number of bone marrow blasts" @default.
• W2071985892 doi "https://doi.org/10.1016/j.bbmt.2004.12.180" @default.
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