An adapted European LeukemiaNet genetic risk stratification for acute myeloid leukemia patients undergoing allogeneic hematopoietic cell transplant. A CIBMTR analysis. Bone Marrow Transplant 2021 Dec;56(12):3068-3077
Date
09/30/2021Pubmed ID
34584240Pubmed Central ID
PMC8758206DOI
10.1038/s41409-021-01450-3Scopus ID
2-s2.0-85115850097 (requires institutional sign-in at Scopus site) 12 CitationsAbstract
Cytogenetic and molecular abnormalities are known to influence post-transplant outcomes in acute myeloid leukemia (AML) but data assessing the prognostic value of combined genetic models in the HCT setting are limited. We developed an adapted European LeukemiaNet (aELN) risk classification based on available genetic data reported to the Center for International Blood and Marrow Transplant Research, to predict post-transplant outcomes in 2289 adult AML patients transplanted in first remission, between 2013 and 2017. Patients were stratified according to aELN into three groups: favorable (Fav, N = 181), intermediate (IM, N = 1185), and adverse (Adv, N = 923). Univariate analysis demonstrated significant differences in 2-year overall survival (OS) (Fav: 67.7%, IM: 64.9% and Adv: 53.9%; p < 0.001); disease-free survival (DFS) (Fav: 57.8%, IM: 55.5% and Adv: 45.3; p < 0.001) and relapse (Fav: 28%, IM: 27.5% and Adv: 37.5%; p < 0.001). Multivariate analysis (MVA) revealed no differences in outcomes between the Fav and IM groups, thus they were combined. On MVA, patients in the Adv risk group had the highest risk of relapse (HR 1.47 p ≤ 0.001) and inferior DFS (HR 1.35 p < 0.001) and OS (HR 1.39 p < 0.001), even using myeloablative conditioning or in those without the pre-HCT measurable-residual disease. Novel approaches to mitigate relapse in this high-risk group are urgently needed.
Author List
Jimenez Jimenez AM, De Lima M, Komanduri KV, Wang TP, Zhang MJ, Chen K, Abdel-Azim H, Abid MB, Aljurf M, Alkhateeb H, Assal A, Bacher U, Baron F, Battiwalla M, Beitinjaneh A, Bejanyan N, Bhatt VR, Byrne M, Cahn JY, Cairo M, Castillo P, Copelan E, DeFilipp Z, Perez MAD, Elsawy M, Gale RP, George B, Grunwald MR, Hildebrandt GC, Hogan WJ, Kanakry CG, Kansagra A, Kharfan-Dabaja MA, Khera N, Krem MM, Lazaryan A, Maakaron J, Martino R, McGuirk J, Michelis FV, Milone G, Mishra A, Murthy HS, Mussetti A, Nathan S, Nishihori T, Olsson RF, Palmisiano N, Patel S, Saad A, Seo S, Sharma A, Solh M, Verdonck LF, Wirk B, Yared JA, Litzow M, Kebriaei P, Hourigan CS, Saber W, Weisdorf DAuthors
Wael Saber MD, MS Professor in the Medicine department at Medical College of WisconsinMei-Jie Zhang PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Hematopoietic Stem Cell TransplantationHumans
Leukemia, Myeloid, Acute
Retrospective Studies
Risk Assessment
Transplantation Conditioning
Transplantation, Homologous