SURVIVAL AND PROGNOSTIC FACTORS OF ACUTE MYELOID LEUKEMIA PATIENTS TREATED WITH ALLOGENEIC HAEMATOPOIETIC STEM CELL TRANSPLANTATION IN MALAYSIA
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Date
2012-07
Authors
ERNEST, MANGANTIG
Journal Title
Journal ISSN
Volume Title
Publisher
Pusat Pengajian Sains Perubatan Universiti Sains Malaysia
Abstract
Introduction: Allogeneic haematopoietic stem cell transplantation (HSCT) activities
for acute myeloid leukemia (AML) patients in Malaysia have increased in recent years,
yet limited studies have report their survival and prognostic factors. The research
findings obtained are expected to help to identify patients that most benefit from the
treatment.
Objectives: To determine the overall survival probabilities and identify prognostic
factors of death among AML patients treated with HSCT in Malaysia.
Methods: A retrospective record review was conducted on 300 AML patients treated
with allogeneic HSCT in Malaysia that registered at the Blood and Bone Marrow
Transplant Registry, National Transplant Registry during the years from 1987 to 2010.
Kaplan-Meier Product Limit Estimates, Simple and Multiple Cox regression were
performed to determine the statistically significant prognostic factors of mortality
among the AML patients in Malaysia.
Results: The 10-year overall survival probability of AML patients treated with
allogeneic HSCT in Malaysia was 63.1% (95% Confidence Interval: 56.8, 68.6). The
10-year overall survival probabilities were found to be significantly different in
performance score, marrow status at transplant, source of stem cells, donor type and
graft-versus-host disease prophylaxis. The significant prognostic factors that were
identified in this study were female donor (Adjusted Hazard Ratio=1.71; 95% CI: 1.10,
2.66; p value=0.016), marrow status second complete remission or beyond (Adjusted
HR=2.00; 95% CI: 1.16, 3.46; p value=0.013), marrow status refractory (Adjusted
HR=4.66; 95% CI: 2.40, 9.06; p value<0.001) and conditioning intensity nonmyeloablative
(Adjusted HR=1.91; 95% CI: 1.21, 3.01; p value=0.005).
Conclusion: AML patients who were treated with allogeneic HSCT in Malaysia were
shown to have good overall survival rate. Thus, HSCT could be the standard option for
suitable patients. Donor’s sex, marrow status and conditioning intensity were the
important prognostic factors of death among the AML patients treated with HSCT in
Malaysia.
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Medical Statistics