Autologous hematopoietic stem-cell transplantation for children with acute myeloid leukemia in first or second complete remission

A prognostic factor analysis

Kamar Godder, Mary Eapen, Joseph H. Laver, Mei Jie Zhang, Bruce M. Camitta, Alan S. Wayne, Robert Peter Gale, John J. Doyle, Lolie C. Yu, Allen R. Chen, James H. Garvin, Eric S. Sandler, Andrew M Yeager, John R. Edwards, Mary M. Horowitz

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Purpose: To determine prognostic factors correlated with outcomes after autologous hematopoietic stem-cell transplantation (HSCT) in children with acute myeloid leukemia (AML). Patients and Methods: We studied 219 children who received autologous HSCT for AML in first complete remission (CR) and 73 children in second CR and who were reported to the Autologous Blood and Marrow Transplant Registry. Among 29 of 73 patients who underwent transplantation in second CR, duration of first CR was ≥ 12 months. Results: Three-year cumulative incidences of relapse were 37% (95% CI, 31% to 44%), 60% (95% CI, 41 % to 74%), and 36% (95% CI, 20% to 53%) for children in first CR, second CR after a short (< 12 months) first CR, and second CR after a long (≥ 12 months) first CR, respectively. Corresponding 3-year probabilities of leukemia-free survival were 54% (95% CI, 47% to 60%), 23% (95% CI, 10% to 39%), and 60% (95% CI, 42% to 75%). In multivariate analyses, risks of relapse, mortality, and treatment failure (relapse or death, inverse of leukemia-free survival) were higher for patients in second CR after a short first CR than for the other two groups. Transplant-related mortality, treatment failure, and overall mortality rates were higher in older (> 10 years) children. Conclusion: Duration of first CR seems to be the most important determinant of outcome. Results in children who experience treatment failure with conventional chemotherapy support the use of autologous transplantation as salvage therapy if such patients achieve a subsequent CR.

Original languageEnglish (US)
Pages (from-to)3798-3804
Number of pages7
JournalJournal of Clinical Oncology
Volume22
Issue number18
DOIs
StatePublished - 2004
Externally publishedYes

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Hematopoietic Stem Cell Transplantation
Acute Myeloid Leukemia
Statistical Factor Analysis
Salvage Therapy
Autologous Transplantation
Treatment Failure
Registries
Transplantation
Bone Marrow
Transplants
Recurrence
Drug Therapy
Incidence

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Autologous hematopoietic stem-cell transplantation for children with acute myeloid leukemia in first or second complete remission : A prognostic factor analysis. / Godder, Kamar; Eapen, Mary; Laver, Joseph H.; Zhang, Mei Jie; Camitta, Bruce M.; Wayne, Alan S.; Gale, Robert Peter; Doyle, John J.; Yu, Lolie C.; Chen, Allen R.; Garvin, James H.; Sandler, Eric S.; Yeager, Andrew M; Edwards, John R.; Horowitz, Mary M.

In: Journal of Clinical Oncology, Vol. 22, No. 18, 2004, p. 3798-3804.

Research output: Contribution to journalArticle

Godder, K, Eapen, M, Laver, JH, Zhang, MJ, Camitta, BM, Wayne, AS, Gale, RP, Doyle, JJ, Yu, LC, Chen, AR, Garvin, JH, Sandler, ES, Yeager, AM, Edwards, JR & Horowitz, MM 2004, 'Autologous hematopoietic stem-cell transplantation for children with acute myeloid leukemia in first or second complete remission: A prognostic factor analysis', Journal of Clinical Oncology, vol. 22, no. 18, pp. 3798-3804. https://doi.org/10.1200/JCO.2004.12.142
Godder, Kamar ; Eapen, Mary ; Laver, Joseph H. ; Zhang, Mei Jie ; Camitta, Bruce M. ; Wayne, Alan S. ; Gale, Robert Peter ; Doyle, John J. ; Yu, Lolie C. ; Chen, Allen R. ; Garvin, James H. ; Sandler, Eric S. ; Yeager, Andrew M ; Edwards, John R. ; Horowitz, Mary M. / Autologous hematopoietic stem-cell transplantation for children with acute myeloid leukemia in first or second complete remission : A prognostic factor analysis. In: Journal of Clinical Oncology. 2004 ; Vol. 22, No. 18. pp. 3798-3804.
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abstract = "Purpose: To determine prognostic factors correlated with outcomes after autologous hematopoietic stem-cell transplantation (HSCT) in children with acute myeloid leukemia (AML). Patients and Methods: We studied 219 children who received autologous HSCT for AML in first complete remission (CR) and 73 children in second CR and who were reported to the Autologous Blood and Marrow Transplant Registry. Among 29 of 73 patients who underwent transplantation in second CR, duration of first CR was ≥ 12 months. Results: Three-year cumulative incidences of relapse were 37{\%} (95{\%} CI, 31{\%} to 44{\%}), 60{\%} (95{\%} CI, 41 {\%} to 74{\%}), and 36{\%} (95{\%} CI, 20{\%} to 53{\%}) for children in first CR, second CR after a short (< 12 months) first CR, and second CR after a long (≥ 12 months) first CR, respectively. Corresponding 3-year probabilities of leukemia-free survival were 54{\%} (95{\%} CI, 47{\%} to 60{\%}), 23{\%} (95{\%} CI, 10{\%} to 39{\%}), and 60{\%} (95{\%} CI, 42{\%} to 75{\%}). In multivariate analyses, risks of relapse, mortality, and treatment failure (relapse or death, inverse of leukemia-free survival) were higher for patients in second CR after a short first CR than for the other two groups. Transplant-related mortality, treatment failure, and overall mortality rates were higher in older (> 10 years) children. Conclusion: Duration of first CR seems to be the most important determinant of outcome. Results in children who experience treatment failure with conventional chemotherapy support the use of autologous transplantation as salvage therapy if such patients achieve a subsequent CR.",
author = "Kamar Godder and Mary Eapen and Laver, {Joseph H.} and Zhang, {Mei Jie} and Camitta, {Bruce M.} and Wayne, {Alan S.} and Gale, {Robert Peter} and Doyle, {John J.} and Yu, {Lolie C.} and Chen, {Allen R.} and Garvin, {James H.} and Sandler, {Eric S.} and Yeager, {Andrew M} and Edwards, {John R.} and Horowitz, {Mary M.}",
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TY - JOUR

T1 - Autologous hematopoietic stem-cell transplantation for children with acute myeloid leukemia in first or second complete remission

T2 - A prognostic factor analysis

AU - Godder, Kamar

AU - Eapen, Mary

AU - Laver, Joseph H.

AU - Zhang, Mei Jie

AU - Camitta, Bruce M.

AU - Wayne, Alan S.

AU - Gale, Robert Peter

AU - Doyle, John J.

AU - Yu, Lolie C.

AU - Chen, Allen R.

AU - Garvin, James H.

AU - Sandler, Eric S.

AU - Yeager, Andrew M

AU - Edwards, John R.

AU - Horowitz, Mary M.

PY - 2004

Y1 - 2004

N2 - Purpose: To determine prognostic factors correlated with outcomes after autologous hematopoietic stem-cell transplantation (HSCT) in children with acute myeloid leukemia (AML). Patients and Methods: We studied 219 children who received autologous HSCT for AML in first complete remission (CR) and 73 children in second CR and who were reported to the Autologous Blood and Marrow Transplant Registry. Among 29 of 73 patients who underwent transplantation in second CR, duration of first CR was ≥ 12 months. Results: Three-year cumulative incidences of relapse were 37% (95% CI, 31% to 44%), 60% (95% CI, 41 % to 74%), and 36% (95% CI, 20% to 53%) for children in first CR, second CR after a short (< 12 months) first CR, and second CR after a long (≥ 12 months) first CR, respectively. Corresponding 3-year probabilities of leukemia-free survival were 54% (95% CI, 47% to 60%), 23% (95% CI, 10% to 39%), and 60% (95% CI, 42% to 75%). In multivariate analyses, risks of relapse, mortality, and treatment failure (relapse or death, inverse of leukemia-free survival) were higher for patients in second CR after a short first CR than for the other two groups. Transplant-related mortality, treatment failure, and overall mortality rates were higher in older (> 10 years) children. Conclusion: Duration of first CR seems to be the most important determinant of outcome. Results in children who experience treatment failure with conventional chemotherapy support the use of autologous transplantation as salvage therapy if such patients achieve a subsequent CR.

AB - Purpose: To determine prognostic factors correlated with outcomes after autologous hematopoietic stem-cell transplantation (HSCT) in children with acute myeloid leukemia (AML). Patients and Methods: We studied 219 children who received autologous HSCT for AML in first complete remission (CR) and 73 children in second CR and who were reported to the Autologous Blood and Marrow Transplant Registry. Among 29 of 73 patients who underwent transplantation in second CR, duration of first CR was ≥ 12 months. Results: Three-year cumulative incidences of relapse were 37% (95% CI, 31% to 44%), 60% (95% CI, 41 % to 74%), and 36% (95% CI, 20% to 53%) for children in first CR, second CR after a short (< 12 months) first CR, and second CR after a long (≥ 12 months) first CR, respectively. Corresponding 3-year probabilities of leukemia-free survival were 54% (95% CI, 47% to 60%), 23% (95% CI, 10% to 39%), and 60% (95% CI, 42% to 75%). In multivariate analyses, risks of relapse, mortality, and treatment failure (relapse or death, inverse of leukemia-free survival) were higher for patients in second CR after a short first CR than for the other two groups. Transplant-related mortality, treatment failure, and overall mortality rates were higher in older (> 10 years) children. Conclusion: Duration of first CR seems to be the most important determinant of outcome. Results in children who experience treatment failure with conventional chemotherapy support the use of autologous transplantation as salvage therapy if such patients achieve a subsequent CR.

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U2 - 10.1200/JCO.2004.12.142

DO - 10.1200/JCO.2004.12.142

M3 - Article

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SP - 3798

EP - 3804

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

SN - 0732-183X

IS - 18

ER -