An adapted European LeukemiaNet genetic risk stratification for acute myeloid leukemia patients undergoing allogeneic hematopoietic cell transplant. A CIBMTR analysis.
Journal
Bone marrow transplantation
ISSN: 1476-5365
Titre abrégé: Bone Marrow Transplant
Pays: England
ID NLM: 8702459
Informations de publication
Date de publication:
12 2021
12 2021
Historique:
received:
13
05
2021
accepted:
23
08
2021
revised:
31
07
2021
pubmed:
30
9
2021
medline:
11
3
2022
entrez:
29
9
2021
Statut:
ppublish
Résumé
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.
Identifiants
pubmed: 34584240
doi: 10.1038/s41409-021-01450-3
pii: 10.1038/s41409-021-01450-3
pmc: PMC8758206
mid: NIHMS1764980
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
3068-3077Subventions
Organisme : NIAID NIH HHS
ID : U01 AI126612
Pays : United States
Organisme : NCI NIH HHS
ID : P01 CA111412
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA215134
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL131731
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL126589
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA152108
Pays : United States
Organisme : NIAID NIH HHS
ID : R01 AI128775
Pays : United States
Organisme : NCI NIH HHS
ID : U24 CA076518
Pays : United States
Organisme : NHLBI NIH HHS
ID : U24 HL138660
Pays : United States
Organisme : NIAID NIH HHS
ID : U01 AI069197
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA231141
Pays : United States
Organisme : NHLBI NIH HHS
ID : UG1 HL069246
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL128568
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL129472
Pays : United States
Organisme : NHLBI NIH HHS
ID : OT3 HL147741
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA218285
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL130388
Pays : United States
Commentaires et corrections
Type : ErratumIn
Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer Nature Limited.
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