The presence of an HLA-identical sibling donor has no impact on outcome of patients with high-risk MDS or secondary AML (sAML) treated with intensive chemotherapy followed by transplantation: results of a prospective study of the EORTC, EBMT, SAKK and GIMEMA Leukemia Groups (EORTC study 06921)

Oosterveld, M;Ferrant, Augustin;Suciu, Stefan;Verhoef, G.;de Witte, T.;et.al.
(2003) Leukemia — Vol. 17, n° 5, p. 859-868 (2003)

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  • Oosterveld, M
    Author
  • Ferrant, AugustinUCLouvain
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  • Suciu, StefanUCLouvain
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  • Verhoef, G.
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  • de Witte, T.
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Abstract
This report used the framework of a large European study to investigate the outcome of patients with and without an HLA-identical sibling donor on an intention-to-treat basis. After a common remission-induction and consolidation course, patients with an HLA-identical sibling donor were scheduled for allogeneic transplantation and patients lacking a donor for autologous transplantation. In all, 159 patients alive at 8 weeks from the start of treatment were included in the present analysis. In total, 52 patients had a donor, 65 patients did not have a donor and in 42 patients the availability of a donor was not assessed. Out of 52 patients, 36 (69%) with a donor underwent allogeneic transplantation (28 in CR1). Out of 65 patients, 33 (49%) received an autograft (27 in CR1). The actuarial survival rates at 4 years were 33.3% (s.e. = 6.7%) for patients with a donor and 39.0% (s.e.=6.50/6) for patients without a donor (P=0.18). Event-free survival rates were 23.1% (s.e.=6.2%) and 21.5% (s.e.=5.3%), respectively (P=0.66). Correction for alternative donor transplants did not substantially alter the survival of the group without a donor. Also, the survival in the various cytogenetic risk groups was not significantly different when comparing the donor vs the no-donor group. This analysis shows that patients with high-risk myelodysplastic syndrome and secondary acute myeloid leukemia may benefit from both allogeneic and autologous transplantation. We were unable to demonstrate a survival advantage for patients with a donor compared to patients without a donor.
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Oosterveld, M., Ferrant, A., Suciu, S., Verhoef, G., Labar, B., Belhabri, A., Aul, C., Selleslag, D., Wijermans, P., Mandelli, F., Amadori, S., Jehn, U., Muus, P., Zittoun, R., Hess, U., Anak, O., Beeldens, F., Willemze, R., & de Witte, T. (2003). The presence of an HLA-identical sibling donor has no impact on outcome of patients with high-risk MDS or secondary AML (sAML) treated with intensive chemotherapy followed by transplantation: results of a prospective study of the EORTC, EBMT, SAKK and GIMEMA Leukemia Groups (EORTC study 06921). Leukemia, 17(5), 859-868. https://doi.org/10.1038/sj.leu.2402897 (Original work published 2003)