Supervivencia a largo plazo de los pacientes trasplantados por leucemia mieloblástica agudaanálisis de los factores de riesgo = Long term survival in patients with acute myeloid leukemia treated with hematopoietic stem cell transplantation. Analysis of risk factors.

Abstract

Acute myeloid leukemia (AML) is a heterogeneous group of leukemias with unique biological and clinical profile and different prognosis, which goes from acute promyelocytic leukemia treated with retinoic acid and chemotherapy, to high risk leukemias which can only be cured with allogeneic transplantation (allo-HSCT). Autologous transplantation (auto-HSCT) has an intermediate role, slightly better than chemotherapy in low risk patients, but also an option in high-risk patients with no suitable donor. The difference is the immune effect called "graft versus leukemia", generally associated with the graft versus host disease (GVHD), both developed after allo-HSCT. This is a retrospective study of 274 adults diagnosed of AML who underwent Hematopoietic Stem Cell Transplantation (HSCT) in Marqués de Valdecilla University Hospital in Santander from March 1982 to December 2011. We analyzed all the genetic samples stored in the Blood and Tissues Bank of Cantabria to complete the biological profile, by FISH and Molecular Biology, of all patients which were not studied at the diagnosis but have available cryopreserved cells from that time. The main objective is to analyze the overall survival, toxicity and relapse in 112 autotransplanted and 162 allotransplanted patients, and also their quality of life with such long-term follow-up. The secondary objective is to analyze the true effect of each prognostic factor (clinical and biological characteristics related to the patient, the disease and its treatment or the procedure) on the cumulative incidence of relapse and the overall survival, with an explaining model which could avoid the confounding effect of the other analyzed variables.