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Allografting

Impact of cytogenetics risk on outcome after reduced intensity conditioning allo-SCT from an HLA-identical sibling for patients with AML in first CR: a report from the acute leukemia working party of EBMT

Bone Marrow Transplantation volume 47, pages 1442–1447 (2012)Cite this article

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Abstract

So far the impact of cytogenetics risk on outcome in the context of reduced intensity conditioning (RIC) allo-SCT has been poorly studied. We have identified 378 AML patients in first CR who underwent RIC allo-SCT from an HLA-matched sibling donor between 2000 and 2007 reported to the European Group for Bone and Marrow Transplantation and for whom detailed cytogenetics data were available (good risk: n=21; intermediate risk: n=304; and poor risk: n=53). With a median follow-up of 24 months (range: 1–93), 2-year non-relapse mortality, relapse rate (RR), leukemia-free survival (LFS) and OS were 14%, 31%, 55% and 61%, respectively. Cytogenetics was significantly associated with RR (good risk: 10%; intermediate risk: 28%; and poor risk: 55% at 2 years, P<0.0001) and LFS (good risk: 64%; intermediate risk: 57%; and poor risk: 38% at 2 years, P=0.003). In a multivariate analysis, RR and LFS were significantly higher and lower, respectively, in the high-risk cytogenetics group (P=0.001, P=0.004) and in patients with a higher WBC at diagnosis (>10 × 109/L) (P<0.001, P=0.004). As documented in the setting of myeloablative allo-SCT, patients with poor cytogenetics had increased RR and decreased LFS after RIC allo-SCT, requiring new prospective strategies to improve results in this subgroup.

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Acknowledgements

We would like to thank all the participating EBMT centers and national registries, local and national data managers. We also thank Emmanuelle Polge and Benedicte Samey for their help in collecting data.

Author contributions: P Chevallier conceived and designed the study, analyzed data, recruited patients, provided clinical care, performed bibliographic search and wrote the manuscript. M Mohty, V Rocha recruited patients, provided clinical care, analyzed data and performed bibliographic search, helped with the statistical analyses and helped writing the manuscript. M Labopin performed data management, collection and statistical analyses. N Milpied, JJ Cornelissen, D Blaise, E Petersen, N Theorin, H Goker, G Socie and V Rocha recruited patients, provided clinical care and commented on the manuscript. All the above authors approved the manuscript for publication purposes.

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  1. V Rocha and M Mohty: These authors share senior authorship

Authors and Affiliations

  1. Department of Haematology, Centre Hospitalier Universitaire (CHU) Hôtel-Dieu, Nantes, France

    P Chevallier & M Mohty

  2. ALWP, EBMT-Paris Office, Hôpital Saint Antoine AP-HP, Université Pierre et Marie Curie Paris 6, UMR-S 893 Equipe 14, Paris, France,

    M Labopin

  3. Department of Haematology, CHU Bordeaux, Hôpital Haut-Lévêque, Pessac, France

    N Milpied

  4. Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam, The Netherlands

    J J Cornelissen

  5. Unité de transplantation et de thérapie Cellulaire, Institut Paoli-Calmette, Marseille, France

    D Blaise

  6. Department of Haematology, University Medical Centre Utrecht, Utrecht, The Netherlands

    E Petersen

  7. Department of Hematology, University Hospital, Linköping, Sweden

    A Sandstedt

  8. Department of Hematology, Hacettepe University, BMT Unit, Ankara, Turkey

    H Goker

  9. Department of Haematology, BMT unit, Hopital Saint-Louis, Paris, France

    G Socie & V Rocha

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  1. P Chevallier
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Chevallier, P., Labopin, M., Milpied, N. et al. Impact of cytogenetics risk on outcome after reduced intensity conditioning allo-SCT from an HLA-identical sibling for patients with AML in first CR: a report from the acute leukemia working party of EBMT. Bone Marrow Transplant 47, 1442–1447 (2012). https://doi.org/10.1038/bmt.2012.55

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