Evidence map›Paper›PMID 30003233›Full record

ArticleJAMA oncology2018

Association of Second Allogeneic Hematopoietic Cell Transplant vs Donor Lymphocyte Infusion With Overall Survival in Patients With Acute Myeloid Leukemia Relapse.

Mohamed A Kharfan-Dabaja, Myriam Labopin, Emmanuelle Polge, Taiga Nishihori, Ali Bazarbachi, Jürgen Finke, Michael Stadler, Gerhard Ehninger, Bruno Lioure, Nicolaas Schaap and 8 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JAMA oncology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 89 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
89citing papers in PubMed, 6 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

89 citing papers in PubMed, 6 syntheses or guidelines pooled it.

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  18. Posttransplant cells for the win? DLI and adoptive cell therapy to eradicate MRD.Hematology. American Society of Hematology. Education Program · 2025
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  20. Article

29 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Mohamed A Kharfan-DabajaDivision of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, Florida.
Myriam LabopinAcute Leukemia Working Party, European Society for Blood and Marrow Transplantation, Paris Study Office, Paris, France.
Emmanuelle PolgeAcute Leukemia Working Party, European Society for Blood and Marrow Transplantation, Paris Study Office, Paris, France.
Taiga NishihoriDepartment of Blood and Marrow Transplantation and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, Florida.
Ali BazarbachiSection of Hematology-Oncology and Bone Marrow Transplantation Program, Department of Internal Medicine, American University of Beirut, Beirut, Lebanon.
Jürgen FinkeDepartment of Medicine, Hematology-Oncology, University of Freiburg, Freiburg, Germany.
Michael StadlerDepartment of Hematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany.
Gerhard EhningerDivision of Hematology, Department of Internal Medicine, Dresden University Hospital, Dresden, Germany.
Bruno LioureDepartment of Hematology and Stem Cell Transplantation, University Hospital, Strasbourg, France.
Nicolaas SchaapRadboud University Medical Centre Nijmegen, Nijmegen, the Netherlands.
Boris AfanasyevFirst State Pavlov Medical University of St. Petersburg Raisa Gorbacheva Memorial Research Institute for Paediatric Oncology, Hematology, and Transplantation, St. Petersburg, Russia.
Moshe YeshurunHematology and BMT Department, Beilinson Hospital, Petach Tikva, Israel.
Cecilia IsakssonDepartment of Hematology, Umeå University Hospital, Umeå, Sweden.
Johan MaertensDepartment of Microbiology and Immunology, Laboratory of Clinical Bacteriology and Mycology, Catholic University Leuven, University Hospitals Leuven, Leuven, Belgium.
Yves ChalandonDivision of Hematology, University of Geneva Hospitals and University of Geneva Medical School, Geneva, Switzerland.
Christoph SchmidSection for Stem Cell Transplantation, Klinikum Augsburg, University of Munich, Munich, Germany.
Arnon NaglerAcute Leukemia Working Party, European Society for Blood and Marrow Transplantation, Paris Study Office, Paris, France.
Mohamad MohtyAcute Leukemia Working Party, European Society for Blood and Marrow Transplantation, Paris Study Office, Paris, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Importance: The optimal treatment approach to patients with acute myeloid leukemia (AML) who relapse after an allogeneic hematopoietic cell transplant (allo-HCT) remains elusive. No randomized clinical trial comparing survival outcomes of a second allo-HCT (allo-HCT2) vs donor lymphocyte infusion (DLI) has been conducted to date. Objective: To compare overall survival (OS) after an allo-HCT2 or DLI in relapsed AML after a first allo-HCT. Design, Setting, and Participants: A retrospective registry study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation involving 418 adults who received an allo-HCT2 (n = 137) or DLI (n = 281) for postallograft-relapsed AML. Analysis was assessed on the principle of intent-to-first received intervention. The data were collected from November 21, 2015, to May 15, 2017, and analysis was performed June 1, 2017. Main Outcomes and Measures: Number of patients with relapsed AML who are alive after 2 years and 5 years from receiving an allo-HCT2 or DLI. Results: Of the 418 patients, 228 (54.5%) were men; mean age was 46.2 years (interquartile range, 36.5-56.9 years). There was no apparent difference in OS whether an allo-HCT2 or DLI was prescribed (2-year OS with allo-HCT2, 26%; 5-year OS with allo-HCT2, 19%; 2-year OS with DLI, 25%; 5-year OS with DLI, 15%; P = .86). Overall survival was better if either of these procedures was offered when the patient was in complete remission (hazard ratio, 0.55; 95% CI, 0.41-0.74; P < .001). Conversely, OS was low for patients relapsing within less than 6 months after an allo-HCT1, regardless of the treatment prescribed (5-year OS: allo-HCT2, 9%; 95% CI, 1%-17% vs DLI, 4%; 95% CI, 1%-8%; P = .86). Conclusion and Relevance: Heterogeneity of the patient-, disease-, and treatment-related characteristics limit the ability to recommend one approach over another. Findings of this study highlight that best outcomes seem to be achieved in patients relapsing 6 or more months from an allo-HCT1 or those in complete remission at the time of either allo-HCT2 or DLI.

Indexed as

Acute DiseaseAdolescentAdultAgedDisease-Free SurvivalFemaleHematopoietic Stem Cell TransplantationHumansLeukemia, MyeloidLymphocyte TransfusionMaleMiddle AgedMultivariate AnalysisRecurrenceRegistriesRemission Induction

Identifiers

PMID30003233
PMCPMC6143013

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.