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Allografting

Evaluation of BM cytomorphology after allo-SCT in patients with AML

Bone Marrow Transplantation volume 47, pages 1538–1544 (2012)Cite this article

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Abstract

Estimation of relapse risk in AML after allo-SCT is critical. The negative impact of increased blast count post transplant is widely accepted. Here, we studied cellularity and dysplasia in BM cytomorphology on days 30 and 100 in 112 AML patients who achieved haematological CR after SCT. Overall cellularity on day 30 was normal in 45.3%, reduced in 37.3% and increased in 17.3% of samples (day 100: normal: 54.8%; reduced: 38.7%; and increased: 6.5%). Dysplasia in ⩾10% of cells was frequent on day 30 (granulopoiesis: 25.0% of samples; erythropoiesis: 34.6%; and megakaryopoiesis: 47.7%) and also on day 100. Relapses were less frequent in patients with normal BM cellularity on day 30 (7/34; 20.6%) when compared with reduced (9/28; 32.1%) or increased cellularity (10/13; 76.9%; P=0.001). Estimated 2-year OS was 59.0% for patients with normal overall cellularity, followed by patients with increased (44.0%) and reduced cellularity (31.4%, P=0.009). In contrast, cellularity at day 100 and dysplasia at days 30 and 100 did not correlate with outcome measures. Thus, in the cohort studied, BM cellularity represents a prognostic parameter for the post-transplant period in AML patients. Dysplasia seems to be an unspecific phenomenon in the cohort analysed.

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Acknowledgements

We acknowledge Waltraud Schultz, University Cancer Centre Hamburg, for expert technical assistance (cytomorphology). We also acknowledge Dr Michael Roth MD, Department of Pediatrics, Montefiore Hospital and Department of Cell Biology, Albert Einstein College of Medicine, Bronx, NY, USA, for critical comments, thoughtful suggestions on data interpretation and critical reading of the manuscript.

Author contributions: MC and UB designed the study and wrote the manuscript. MC, KM, MB, PS and UB performed cytomorphology. KM, TZ, MB and UB assembled data. MC, EK and UB carried out statistical analysis. FA, CB and NK contributed patients. TH and NK contributed to the interpretation of data. All authors contributed to data analysis, reviewed the manuscript and approved its final version.

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  1. M Christopeit

    Present address: Department of Cell Biology, Albert Einstein College of Medicine, Bronx, NY, USA.,

Authors and Affiliations

  1. Department of Internal Medicine, Oncology and Haematology, University Hospital Halle (Saale), Halle (Saale), Germany

    M Christopeit

  2. Department for Stem Cell Transplantation, University Cancer Center Hamburg, Hamburg, Germany

    K Miersch, E Klyuchnikov, T Zabelina, F Ayuk, A R Zander, N Kröger & U Bacher

  3. MLL Munich Leukemia Laboratory, Munich, Germany

    T Haferlach

  4. Department of Internal Medicine II, University Cancer Center Hamburg, Hamburg, Germany

    M Binder, P Schafhausen & C Bokemeyer

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Correspondence to U Bacher.

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Competing interests

Data have been assembled during the course of the doctoral thesis of KM. MC has received honoraria and travel support from Celgene. TH declares part ownership of the Munich Leukemia Laboratory GmbH. All other authors have no conflict of interest to declare.

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Christopeit, M., Miersch, K., Klyuchnikov, E. et al. Evaluation of BM cytomorphology after allo-SCT in patients with AML. Bone Marrow Transplant 47, 1538–1544 (2012). https://doi.org/10.1038/bmt.2012.70

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