An adapted European LeukemiaNet genetic risk stratification for acute myeloid leukemia patients undergoing allogeneic hematopoietic cell transplant. A CIBMTR analysis

Antonio M. Jimenez Jimenez, Marcos De Lima, Krishna V. Komanduri, Trent P. Wang, Mei Jie Zhang, Karen Chen, Hisham Abdel-Azim, Muhammad Bilal Abid, Mahmoud Aljurf, Hassan Alkhateeb, Amer Assal, Ulrike Bacher, Frédéric Baron, Minoo Battiwalla, Amer Beitinjaneh, Nelli Bejanyan, Vijaya Raj Bhatt, Michael Byrne, Jean Yves Cahn, Mitchell CairoPaul Castillo, Edward Copelan, Zachariah DeFilipp, Miguel Angel Diaz Perez, Mahmoud Elsawy, Robert Peter Gale, Biju George, Michael R. Grunwald, Gerhard C. Hildebrandt, William J. Hogan, Christopher G. Kanakry, Ankit Kansagra, Mohamed A. Kharfan-Dabaja, Nandita Khera, Maxwell M. Krem, Aleksandr Lazaryan, Joseph Maakaron, Rodrigo Martino, Joseph McGuirk, Fotios V. Michelis, Giuseppe Milone, Asmita Mishra, Hemant S. Murthy, Alberto Mussetti, Sunita Nathan, Taiga Nishihori, Richard F. Olsson, Neil Palmisiano, Sagar Patel, Ayman Saad, Sachiko Seo, Akshay Sharma, Melhem Solh, Leo F. Verdonck, Baldeep Wirk, Jean A. Yared, Mark Litzow, Partow Kebriaei, Christopher S. Hourigan, Wael Saber, Daniel Weisdorf

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
JournalBone Marrow Transplantation
DOIs
StateAccepted/In press - 2021

All Science Journal Classification (ASJC) codes

  • Hematology
  • Transplantation

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