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Blood, 1 November 2002, Vol. 100, No. 9, pp. 3135-3140
CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS
Hematopoietic stem cell transplantation for de novo
erythroleukemia: a study of the European Group for Blood and Marrow
Transplantation (EBMT)
Loïc Fouillard,
Myriam Labopin,
Norbert-Claude Gorin,
Emmanuelle Polge,
Hugh Grant Prentice,
Giovanna Meloni,
Josy Reiffers,
Arnaud Pigneux,
Roel Willemze,
Anton Schattenberg,
Simona Sica,
Monique Lagrange,
Odile Fenneteau,
Christine Perot, and
Francesco Frassoni for the Acute
Leukemia Working Party of the
EBMT
From the Centre International Greffe de Moelle (EBMT),
Centre de Recherche Claude Bernard sur la Thérapie Cellulaire,
Université Pierre et Marie Curie Paris VI: Institut des
Cordeliers, Paris; Department of Hematology, Laboratory of Hematology,
and Laboratory of Cytogenetics, Hôpital Saint-Antoine, Paris;
Laboratory of Hematology, Hôpital Robert Debré, Paris; CHU
Bordeaux, Hôpital Haut Lévêque, Pessac, France;
Department of Haematology, Royal Free Hospital and University College
Medical School, London, England; Dipartimento di Biotecnologie
Cellulari e Ematologica, University La Sapienza, Rome; Department of
Hematology, Universita Cattolica S Cuore, Rome; Department of
Hematology, Ospedale San Martino, Genoa, Italy; BMT Centre Leiden,
Leiden University Hospital; and Medical Centre, Nijmegen, The
Netherlands.
De novo erythroleukemia (EL) is a rare disease. Reported median
survival are poor and vary from 4 to 14 months. The value of
hematopoietic stem cell transplantation (HSCT) for EL is unknown. This
EBMT registry study reports on the largest series of patients with EL
treated with HSCT in first complete remission 103 autologous and 104 HLA identical sibling allogeneic HSCT. Outcome and identification of
prognostic factors for each type of transplantation were evaluated. For
autologous HSCT, outcome at 5 years showed a leukemia-free survival
(LFS) of 26% ± 5%, a relapse incidence (RI) of 70% ± 6%, and
a transplant-related mortality (TRM) of 13% ± 4%. By multivariate analysis, the only prognostic factor was age. For allogeneic HSCT, outcome at 5 years showed an LFS of 57% ± 5%, an RI of
21% ± 5%, and a TRM of 27% ± 5%. By multivariate analysis,
prognostic factors were graft-versus-host disease and age. This study
represents the largest series of de novo EL treated with HSCT and shows
that allogeneic HSCT is by far the most effective treatment.
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