Biology of Blood and Marrow Transplantation
Volume 15, Issue 11 , Pages 1431-1438 , November 2009

Quantifying the Survival Benefit for Allogeneic Hematopoietic Stem Cell Transplantation in Relapsed Acute Myelogenous Leukemia

  • Paul M. Armistead

      Affiliations

    • Department of Stem Cell Transplantation and Cellular Therapy, M.D. Anderson Cancer Center, Houston Texas
    • Corresponding Author InformationCorrespondence and reprint requests: Paul Armistead, MD, PhD, Lineberger Comprehensive Cancer Center, 21-244, University of North Carolina, 450 West Road, Chapel Hill, NC 27599.
  • ,
  • Marcos de Lima

      Affiliations

    • Department of Stem Cell Transplantation and Cellular Therapy, M.D. Anderson Cancer Center, Houston Texas
  • ,
  • Sherry Pierce

      Affiliations

    • Department of Leukemia, M.D. Anderson Cancer Center, Houston Texas
  • ,
  • Wei Qiao

      Affiliations

    • Department of Biostatistics, M.D. Anderson Cancer Center, Houston Texas
  • ,
  • Xuemei Wang

      Affiliations

    • Department of Biostatistics, M.D. Anderson Cancer Center, Houston Texas
  • ,
  • Peter F. Thall

      Affiliations

    • Department of Biostatistics, M.D. Anderson Cancer Center, Houston Texas
  • ,
  • Sergio Giralt

      Affiliations

    • Department of Stem Cell Transplantation and Cellular Therapy, M.D. Anderson Cancer Center, Houston Texas
  • ,
  • Farhad Ravandi

      Affiliations

    • Department of Leukemia, M.D. Anderson Cancer Center, Houston Texas
  • ,
  • Hagop Kantarjian

      Affiliations

    • Department of Leukemia, M.D. Anderson Cancer Center, Houston Texas
  • ,
  • Richard Champlin

      Affiliations

    • Department of Stem Cell Transplantation and Cellular Therapy, M.D. Anderson Cancer Center, Houston Texas
  • ,
  • Elihu Estey

      Affiliations

    • Fred Hutchinson Cancer Research Center, Seattle, Washington

Received 27 May 2009 ,Accepted 9 July 2009.

  • Image Result

    Flow chart of patient treatments. Of 599 evaluable patients, 67 died during first salvage chemotherapy and 42 underwent HSCT as their first salvage therapy (both shown in gray boxes). These groups wer

    Flow chart of patient treatments. Of 599 evaluable patients, 67 died during first salvage chemotherapy and 42 underwent HSCT as their first salvage therapy (both shown in gray boxes). These groups were not used in this analysis. The remaining 490 patients were evaluable; of these, 112 patients achieved CR, and 378 did not. After first salvage therapy, 94 patients did not undergo further treatment (shown in gray box) and were subsequently excluded from further analysis, leaving 396 patients for analysis.

  • Image Result
    Overall survival of patient cohorts. Kaplan-Meier survival probability curves were generated to evaluate overall survival probability for the entire evaluable cohort. A, Overall survival for the entir

    Overall survival of patient cohorts. Kaplan-Meier survival probability curves were generated to evaluate overall survival probability for the entire evaluable cohort. A, Overall survival for the entire cohort according to treatment modality. B, Overall survival in patients who underwent HSCT in first salvage–induced CR. C, Overall survival in patients who underwent HSCT as second salvage. In all 3 analyses, a statistically significant survival advantage was observed in the HSCT cohorts.

  • Image Result
    First multiple-subgroup analysis. Kaplan-Meier survival probability curves were generated for subgroups based on remission status following first salvage, age, and cytogenetics as described in the hea

    First multiple-subgroup analysis. Kaplan-Meier survival probability curves were generated for subgroups based on remission status following first salvage, age, and cytogenetics as described in the heading for each curve. The letter heading for each curve matches the prognostic factors and survival data described in Table 3.

  • Image Result
    Second multiple-subgroup analysis. Kaplan-Meier survival probability curves were generated for subgroups based on the known prognostic factors of age and duration of CR1, as described in the heading f

    Second multiple-subgroup analysis. Kaplan-Meier survival probability curves were generated for subgroups based on the known prognostic factors of age and duration of CR1, as described in the heading for each curve. The letter heading for each curve matches the prognostic factors and survival data described in Table 4.

 Financial disclosure: See Acknowledgments on page 1437.

PII: S1083-8791(09)00338-3

doi: 10.1016/j.bbmt.2009.07.008

Biology of Blood and Marrow Transplantation
Volume 15, Issue 11 , Pages 1431-1438 , November 2009