Cytogenetic risk score maintains its prognostic significance inAMLpatients with detectable measurable residual disease undergoing transplantation in remission: On behalf of the acute leukemia working party of the European society for blood and marrow transplantation - UTU Research Portal

A1 Refereed original research article in a scientific journal

Cytogenetic risk score maintains its prognostic significance inAMLpatients with detectable measurable residual disease undergoing transplantation in remission: On behalf of the acute leukemia working party of the European society for blood and marrow transplantation

Authors: Arnon Nagler, Myriam Labopin, Jonathan Canaani, Riitta Niittyvuopio, Gerard Socié, Nicolaus Kröger, Maija Itälä‐Remes, Ibrahim Yakoub‐Agha, Hélène Labussière‐Wallet, Maria P. Gallego‐Hernanz, Eric Deconinck, Patrice Chevallier, Jürgen Finke, Jordi Esteve, Mohamad Mohty

Publisher: WILEY

Publication year: 2020

Journal: American Journal of Hematology

Journal name in source: AMERICAN JOURNAL OF HEMATOLOGY

Journal acronym: AM J HEMATOL

Volume: 95

Issue: 10

Number of pages: 7

ISSN: 0361-8609

DOI: https://doi.org/10.1002/ajh.25905(external)

Abstract

While evidence for measurable residual disease (MRD) is a harbinger of inferior outcome in acute myeloid leukemia (AML) patients referred for allogeneic stem cell transplantation (allo-SCT), the exact clinical trajectory of specific patient subsets in this clinical setting is undefined. Using a recently published prognostic cytogenetic model (Canaani et al. Leukemia 2019) we evaluated whether this model applied also to studies of patients with positive MRD. The analysis comprised MRD(+)patients in first complete remission undergoing allo-SCT from a matched sibling donor or unrelated donor. Seven hundred and seventy-five patients were evaluated with a median follow-up duration of 22 months. Cytogenetic risk score was favorable, intermediate/FLT3(wt)intermediate/FLT3-ITD3, and adverse in 15%, 28.3%, 37% and 19.7% of the patients, respectively. Favorable and intermediate/FLT3(wt)risk patients had 2-year leukemia-free survival rates of 78% and 61%, respectively, compared with only 50% and 37% for intermediate/FLT3-ITD3and adverse risk patients, respectively (P< .001). In multivariate analysis adverse and intermediate/FLT3-ITD3risk patients were more likely to experience disease relapse compared with favorable risk patients [hazard ratio (HR) = 3.9, 95% confidence interval (CI), 2.1-7.3;P< .001, and HR = 4.4, CI 95%, 2.4-7.8;P< .001, respectively]. The European society for blood and marrow transplantation cytogenetic risk score is a valuable adjunct for risk stratification of MRD(+)AML patients.