Stefan O Ciurea1, Myriam Labopin2,3, Gerard Socie4, Liisa Volin5, Jakob Passweg6, Patrice Chevallier7, Dietrich Beelen8, Noel Milpied9, Didier Blaise10, Jan J Cornelissen11, Nathalie Fegueux12, Emmanuelle Polge2,3, Piyanuch Kongtim1, Gabriela Rondon1, Jordi Esteve3, Mohamad Mohty13, Bipin N Savani2,14, Richard E Champlin1, Arnon Nagler2,15. 1. Department of Stem Cell Transplant and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Texas. 2. Acute Leukemia Working Party, European Society for Blood and Marrow Transplantation, Paris Study Office/European Center for Biostatistical and Epidemiological Evaluation in Hematopoietic Cell Therapy, Paris, France. 3. Institute of Hematology and Oncology, Department of Hematology, Hospital Clinic, August Pi I Sunyer Institute for Biomedical Investigation (IDIBAPS), University of Barcelona, Barcelona, Spain. 4. Department of Hematology, St. Louis Hospital, Paris, France. 5. Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland. 6. Department of Hematology, University Hospital Basel, Basel, Switzerland. 7. Department of Hematology, Hotel-Dieu University Hospital Center, Nantes, France. 8. Department of Bone Marrow Transplantation, University Hospital, Essen, Essen, Germany. 9. Department of Hematology and Cellular Therapy, Bordeaux University Hospital Center, Haut-Leveque Hospital, Pessac, France. 10. Transplantation and Cellular Therapy Program, Marseille Center for Oncology Research, Paoli Calmettes Institute, Marseille, France. 11. Department of Hematology, Erasmus Medical Center Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands. 12. Department of Clinical Hematology, Lapeyronie University Hospital Center, Montpellier, France. 13. Hematology and Cellular Therapy Department, Saint-Antoine Hospital, Pierre and Marie Curie University, Paris, France. 14. Long-Term Transplantation Clinic, Vanderbilt University Medical Center, Nashville, Tennessee. 15. Hematology Division, Chaim Sheba Medical Center, Tel Hashomer, Tel Aviv University, Tel Aviv, Israel.
Abstract
BACKGROUND: Despite recent advances in allogeneic hematopoietic stem cell transplantation (AHSCT), the outcome of patients who have acute myeloid leukemia (AML) with a complex karyotype (CK) remains poor. The objective of this study was to identify prognostic factors associated with post-transplantation survival in a large cohort of patients with CK AML. METHODS: In total, data on 1342 consecutively patients who underwent transplantation for CK (≥3 chromosomal abnormalities) AML were provided by the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation and from the University of Texas MD Anderson Cancer Center database were included in the analysis. The median patient age was 52 years. The donors were human leukocyte antigen-matched related donors (N = 749), matched unrelated donors (N = 513), and mismatched unrelated donors (N = 80). RESULTS: Relapse was the main cause of treatment failure. Overall, 51% of patients relapsed, 17.6% died of treatment-related mortality, and 31.3% survived leukemia-free. In multivariate analysis, the factors associated with an increased risk of relapse were age (>40 years; hazard ratio [HR], 1.1 per 10 years; P = .02), secondary AML (HR, 1.35; P = .01), active disease at transplantation (HR, 1.98; P < .001), and deletion/monosomy 5 (HR, 1.5; P < .001); whereas age (HR, 1.15 per 10 years; P < .001), secondary AML (HR, 1.36; P = .001), active disease at transplantation (HR, 1.99; P < .001), deletion/monosomy 5 (HR, 1.24; P = .008), and deletion/monosomy 7 (HR, 1.44; P < .001) predicted for leukemia-free survival. CONCLUSIONS: Disease relapse remains the most common cause of treatment failure for patients with CK AML after transplantation. Novel approaches to decrease the relapse rate and improve survival are needed in these patients. Cancer 2018;124:2134-41.
BACKGROUND: Despite recent advances in allogeneic hematopoietic stem cell transplantation (AHSCT), the outcome of patients who have acute myeloid leukemia (AML) with a complex karyotype (CK) remains poor. The objective of this study was to identify prognostic factors associated with post-transplantation survival in a large cohort of patients with CK AML. METHODS: In total, data on 1342 consecutively patients who underwent transplantation for CK (≥3 chromosomal abnormalities) AML were provided by the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation and from the University of Texas MD Anderson Cancer Center database were included in the analysis. The median patient age was 52 years. The donors were human leukocyte antigen-matched related donors (N = 749), matched unrelated donors (N = 513), and mismatched unrelated donors (N = 80). RESULTS: Relapse was the main cause of treatment failure. Overall, 51% of patients relapsed, 17.6% died of treatment-related mortality, and 31.3% survived leukemia-free. In multivariate analysis, the factors associated with an increased risk of relapse were age (>40 years; hazard ratio [HR], 1.1 per 10 years; P = .02), secondary AML (HR, 1.35; P = .01), active disease at transplantation (HR, 1.98; P < .001), and deletion/monosomy 5 (HR, 1.5; P < .001); whereas age (HR, 1.15 per 10 years; P < .001), secondary AML (HR, 1.36; P = .001), active disease at transplantation (HR, 1.99; P < .001), deletion/monosomy 5 (HR, 1.24; P = .008), and deletion/monosomy 7 (HR, 1.44; P < .001) predicted for leukemia-free survival. CONCLUSIONS: Disease relapse remains the most common cause of treatment failure for patients with CK AML after transplantation. Novel approaches to decrease the relapse rate and improve survival are needed in these patients. Cancer 2018;124:2134-41.
Authors: Enrico Maffini; Myriam Labopin; Dietrich Wilhelm Beelen; Nicolaus Kroeger; Mutlu Arat; Keith M O Wilson; Jacques-Olivier Bay; Arnold Ganser; Hans Martin; Jakob Passweg; Panagiotis D Kottaridis; Ibrahim Yakoub-Agha; Rocio Parody Porras; Eva Maria Wagner; Jordi Esteve; Francesco Lanza; Arnon Nagler; Mohamad Mohty Journal: Bone Marrow Transplant Date: 2022-07-14 Impact factor: 5.174
Authors: Dean A Lee; Richard E Champlin; Stefan O Ciurea; Piyanuch Kongtim; Doris Soebbing; Prashant Trikha; Gregory Behbehani; Gabriela Rondon; Amanda Olson; Qaiser Bashir; Alison M Gulbis; Kaur Indreshpal; Katayoun Rezvani; Elizabeth J Shpall; Roland Bassett; Kai Cao; Andrew St Martin; Steven Devine; Mary Horowitz; Marcelo Pasquini Journal: Leukemia Date: 2021-07-26 Impact factor: 12.883