Cytogenetic risk score maintains its prognostic significance in AML patients with detectable measurable residual disease undergoing transplantation in remission: on behalf of the ALWP/EBMT.
Fiche publication
Date publication
juin 2020
Journal
American journal of hematology
Auteurs
Membres identifiés du Cancéropôle Est :
Pr DECONINCK Eric
Tous les auteurs :
Nagler A, Labopin M, Canaani J, Niittyvuopio R, Socié G, Kröger N, Itäla-Remes M, Yakoub-Agha I, Labussière-Wallet H, Gallego-Hernanz MP, Deconinck E, Chevallier P, Finke J, Esteve J, Mohty M
Lien Pubmed
Résumé
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 (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 intermediate/FLT3-ITD, and adverse in 15%, 28.3%, 37% and 19.7% of the patients, respectively. Favorable and intermediate/FLT3 risk patients had 2-year leukemia-free survival rates of 78% and 61%, respectively, compared with only 50% and 37% for intermediate FLT3-ITD and adverse risk patients, respectively (p<0.0001). In multivariate analysis adverse and intermediate/FLT3-ITD risk 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<0.0001, and HR=4.4, CI 95%, 2.4-7.8; p<0.0001, respectively]. The EBMT cytogenetic risk score is a valuable adjunct for risk stratification of MRD AML patients. This article is protected by copyright. All rights reserved.
Référence
Am. J. Hematol.. 2020 Jun 12;: