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Acute Leukemia

Treatment strategies in patients with AML or high-risk myelodysplastic syndrome relapsed after Allo-SCT

Bone Marrow Transplantation volume 50, pages 485–492 (2015)Cite this article

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Abstract

Non-relapse mortality after Allo-SCT has significantly decreased over the last years. Nevertheless, relapse remains a major cause for post SCT mortality in patients with AML and high-risk myelodysplastic syndrome (MDS). In this retrospective single-center analysis, we have analyzed the treatment outcomes of 108 patients with AML or MDS, who relapsed after Allo-SCT. Seventy of these patients (65%) were treated with salvage therapies containing chemotherapy alone, allogeneic cell-based treatment or the combination of both. Thirty-eight patients (35%) received palliative treatment. Median OS after diagnosis of relapse was 130 days. Compared with patients who received chemotherapy alone, response to salvage therapy was significantly improved in patients treated with a combination of chemo- and allogeneic cell-based therapy (CR rate 57% vs 13%, P=0.002). Among risk factors concerning pretreatment characteristics, disease status before first Allo-SCT, and details of transplantation, only the time interval from Allo-SCT to relapse was an independent predictor of response to salvage therapy and OS. These data confirmed that time to relapse after transplantation is an important prognostic factor. Up to now, only patients eligible for treatment regimens containing allogeneic cell-based interventions achieved relevant response rates.

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Acknowledgements

We would like to thank the staff of our department for their excellent work and all patients.

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Authors and Affiliations

  1. Department of Internal Medicine A, Hematology and Oncology, University of Muenster, Muenster, Germany

    T Sauer, G Silling, C Groth, F Rosenow, U Krug, G Evers, J Albring, R M Mesters, C Müller-Tidow, T Kessler, T Büchner, W E Berdel & M Stelljes

  2. Institute of Biostatistics and Clinical Research, University of Muenster, Muenster, Germany

    D Görlich

  3. Institute of Human Genetics, University of Muenster, Muenster, Germany

    R Besoke

  4. Department of Medicine IV, Hematology and Oncology, University of Halle, Halle, Germany

    C Müller-Tidow

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  1. T Sauer
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Sauer, T., Silling, G., Groth, C. et al. Treatment strategies in patients with AML or high-risk myelodysplastic syndrome relapsed after Allo-SCT. Bone Marrow Transplant 50, 485–492 (2015). https://doi.org/10.1038/bmt.2014.300

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