TY - JOUR
T1 - Relapse and survival after transplantation for complex karyotype acute myeloid leukemia
T2 - A report from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation and the University of Texas MD Anderson Cancer Center
AU - Ciurea, Stefan O.
AU - Labopin, Myriam
AU - Socie, Gerard
AU - Volin, Liisa
AU - Passweg, Jakob
AU - Chevallier, Patrice
AU - Beelen, Dietrich
AU - Milpied, Noel
AU - Blaise, Didier
AU - Cornelissen, Jan J.
AU - Fegueux, Nathalie
AU - Polge, Emmanuelle
AU - Kongtim, Piyanuch
AU - Rondon, Gabriela
AU - Esteve, Jordi
AU - Mohty, Mohamad
AU - Savani, Bipin N.
AU - Champlin, Richard E.
AU - Nagler, Arnon
N1 - Funding Information:
Corresponding author: Stefan O. Ciurea, MD, Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 423, Houston, TX 77030; sciurea@mdanderson.org 1Department of Stem Cell Transplant and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Texas; 2Acute 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; 3Institute of Hematology and Oncology, Department of Hematology, Hospital Clinic, August Pi I Sunyer Institute for Biomedical Investigation (IDI-BAPS), University of Barcelona, Barcelona, Spain; 4Department of Hematology, St. Louis Hospital, Paris, France; 5Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland; 6Department of Hematology, University Hospital Basel, Basel, Switzerland; 7Department of Hematology, Hotel-Dieu University Hospital Center, Nantes, France; 8Department of Bone Marrow Transplantation, University Hospital, Essen, Essen, Germany; 9Department of Hematology and Cellular Therapy, Bordeaux University Hospital Center, Haut-Leveque Hospital, Pessac, France; 10Transplantation and Cellular Therapy Program, Marseille Center for Oncology Research, Paoli Calmettes Institute, Marseille, France; 11Department of Hematology, Erasmus Medical Center Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands; 12Department of Clinical Hematology, Lapeyronie University Hospital Center, Montpellier, France; 13Hematology and Cellular Therapy Department, Saint-Antoine Hospital, Pierre and Marie Curie University, Paris, France; 14Long-Term Transplantation Clinic, Vanderbilt University Medical Center, Nashville, Tennessee; 15Hematology Division, Chaim Sheba Medical Center, Tel Hashomer, Tel Aviv University, Tel Aviv, Israel Presented in part as an oral presentation at the meeting of the American Society for Blood and Marrow Transplantation; February 22-26, 2017; Orlando, Florida; and at the 43rd Annual Meeting of the European Society for Blood and Marrow Transplantation; March 26-29, 2017; Marseille, France.
Publisher Copyright:
© 2018 American Cancer Society
PY - 2018/5/15
Y1 - 2018/5/15
N2 - 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.
AB - 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.
KW - acute myeloid leukemia
KW - allogeneic stem cell transplantation
KW - complex karyotype
KW - myeloablative conditioning
KW - reduced-intensity conditioning
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U2 - 10.1002/cncr.31311
DO - 10.1002/cncr.31311
M3 - Article
C2 - 29469961
AN - SCOPUS:85042376784
SN - 0008-543X
VL - 124
SP - 2134
EP - 2141
JO - Cancer
JF - Cancer
IS - 10
ER -