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Blood, 1 May 2007, Vol. 109, No. 9, pp. 3658-3666.
Prepublished online as a Blood First Edition Paper on January 9, 2007; DOI 10.1182/blood-2006-06-025627.
 Previous Article | Next Article 
Submitted June 1, 2006
Accepted December 28, 2006
Myeloablative HLA-identical sibling stem cell transplantation in first remission acute myeloid leukemia in young and middle aged adults: benefits for whom? results of a HOVON/SAKK donor versus no donor analysis
Jan J. Cornelissen*, Wim L.J. van Putten, Leo F. Verdonck, Matthias Theobald, Emanuel Jacky, Simon M.G. Daenen, Marinus van Marwijk Kooy, Pierre Wijermans, Harry Schouten, Peter C. Huijgens, Hans van der Lelie, Martin Fey, Augustin Ferrant, Johan Maertens, Alois Gratwohl, and Bob Lowenberg
Erasmus University Medical Center, Rotterdam, Netherlands
Johannes Gutenberg University, Mainz, Germany
University Medical Center, Utrecht, Netherlands
University Hospital, Zurich, Switzerland
University Medical Center, Groningen, Netherlands
Isala Klinieken, Zwolle, Netherlands
Haga Hospital, Den Haag, Netherlands
University Hospital, Maastricht, Netherlands
VU Medical Center, Amsterdam, Netherlands
Amsterdam Medical Center, Amsterdam, Netherlands
University Hospital, Bern, Switzerland
Cliniques Universitaires Saint-Luc, Brussels, Belgium
University Hospital Gasthuisberg, Leuven, Belgium
Kantonsspital, Basel, Switzerland
* Corresponding author; email: j.cornelissen{at}erasmusmc.nl.
The HOVON-SAKK collaborative study group evaluated outcome of patients (pts) with AML in first remission (CR1) entered in 3 consecutive studies according a donor versus no donor comparison. Between 1987 and 2004, 2287 pts were entered in these studies of whom 1032 pts (45%) without FAB M3 or t(15;17) were in CR1 after 2 cycles of chemotherapy, received consolidation treatment, and were younger than 55 years of age and therefore eligible for allo-SCT. An HLA-identical sibling donor was available for 326 pts (32%), while 599 pts (58%) lacked such a donor and information was not available in 107 pts. Compliance with allo-SCT was 82% (268 out of 326). Cumulative incidences of relapse were, respectively, 32% versus 59% for pts with versus those without a donor (P<0.001). Despite more treatment related mortality (TRM) in the donor group (21% versus 4%, P<0.001), disease free survival (DFS) appeared significantly better in the donor group (48% (±3) versus 37% (±2) in the no-donor group, P<0.001). Following risk-group analysis, DFS was significantly better for pts with a donor and an intermediate (P=0.01) or poor risk profile (P=0.003) and also better in pts younger than 40 years of age (P<0.001). We evaluated our results and those of the previous MRC, BGMT and EORTC studies in a meta-analysis, which revealed a significant benefit of 12% in overall survival (OS) by donor availability for all patients with AML in CR1 without a favorable cytogenetic profile.
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