Faculty Collaboration Database

Risk classification at diagnosis predicts post-HCT outcomes in intermediate-, adverse-risk, and KMT2A-rearranged AML. Blood Adv 2022 Jan 08;6(3):828-847

Date

09/23/2021

Pubmed ID

34551064

Pubmed Central ID

PMC8945306

DOI

10.1182/bloodadvances.2021004881

Scopus ID

2-s2.0-85124675874 (requires institutional sign-in at Scopus site)   5 Citations

Abstract

Little is known about whether risk classification at diagnosis predicts post-hematopoietic cell transplantation (HCT) outcomes in patients with acute myeloid leukemia (AML). We evaluated 8709 patients with AML from the CIBMTR database, and after selection and manual curation of the cytogenetics data, 3779 patients in first complete remission were included in the final analysis: 2384 with intermediate-risk, 969 with adverse-risk, and 426 with KMT2A-rearranged disease. An adjusted multivariable analysis detected an increased risk of relapse for patients with KMT2A-rearranged or adverse-risk AML as compared to those with intermediate-risk disease (hazards ratio [HR], 1.27; P = .01; HR, 1.71; P < .001, respectively). Leukemia-free survival was similar for patients with KMT2A rearrangement or adverse risk (HR, 1.26; P = .002, and HR, 1.47; P < .001), as was overall survival (HR, 1.32; P < .001, and HR, 1.45; P < .001). No differences in outcome were detected when patients were stratified by KMT2A fusion partner. This study is the largest conducted to date on post-HCT outcomes in AML, with manually curated cytogenetics used for risk stratification. Our work demonstrates that risk classification at diagnosis remains predictive of post-HCT outcomes in AML. It also highlights the critical need to develop novel treatment strategies for patients with KMT2A-rearranged and adverse-risk disease.

Author List

Menghrajani K, Gomez-Arteaga A, Madero-Marroquin R, Zhang MJ, Bo-Subait K, Sanchez J, Wang HL, Aljurf M, Assal A, Bacher VU, Badawy SM, Bejanyan N, Bhatt VR, Bredeson C, Byrne M, Castillo P, Cerny J, Chhabra S, Ciurea SO, DeFilipp Z, Farhadfar N, Gadalla S, Gale RP, Ganguly S, Gowda L, Grunwald MR, Hashmi S, Hildebrandt G, Kanakry CG, Kansagra A, Khimani F, Krem M, Lazarus H, Liu H, Martino R, Michelis FV, Nathan S, Nishihori T, Olsson R, Reshef R, Rizzieri D, Rowe JM, Savani BN, Seo S, Sharma A, Solh M, Ustun C, Verdonck LF, Hourigan C, Sandmaier B, Litzow M, Kebriaei P, Weisdorf D, Zhang Y, Tallman MS, Saber W

Authors

Wael Saber MD, MS Professor in the Medicine department at Medical College of Wisconsin
Mei-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 Transplantation
Humans
Leukemia, Myeloid, Acute
Recurrence
Remission Induction