Better leukemia-free survival with allogeneic than with autologous HCT in AML patients with isolated trisomy 8: a study from the ALWP of the EBMT


The indication for performing an allogeneic hematopoietic stem cell transplantation (allo-HCT) in patients with isolated trisomy 8 AML in first complete remission (CR) is still debated. Here, we compared outcomes of such patients given either allo-HCT or autologous (auto)-HCT. Inclusion criteria consisted of adult patients with de novo AML, isolated trisomy 8, first HCT between 2000 and 2018, CR1 at transplantation, and either auto-HCT or allo-HCT with a HLA-identical sibling donor (MSD) or a 10/10 HLA-matched unrelated donor (UD 10/10). A total of 401 patients met the inclusion criteria. They underwent an auto-HCT (n = 81), allo-HCT with a MSD (n = 186) or allo-HCT with a 10/10 UD (n = 134). At 3 years, relapse incidence, nonrelapse mortality and leukemia-free survival (LFS) were 59%, 5%, and 37%, respectively, in auto-HCT recipients; 31% (P < 0.001), 14% (P = 0.04), and 55% (P = 0.033), respectively, in MSD recipients and 29% (P < 0.001), 13% (P = 0.15), and 59% (P = 0.03), respectively, in UD 10/10 recipients. In multivariate analysis, in comparison to auto-HCT, MSD and UD 10/10 were associated with a lower risk of relapse (HR = 0.47, P < 0.001 and HR = 0.40, P < 0.001, respectively) translating to better LFS (HR = 0.69, P = 0.04 and HR = 0.60, P = 0.03, respectively). There was also a similar trend for overall survival (HR = 0.73, P = 0.12 and HR = 0.65, P = 0.08).

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.

Fig. 1: Relapse and nonrelapse mortality.
Fig. 2


  1. 1.

    Grimwade D, Walker H, Harrison G, Oliver F, Chatters S, Harrison C, et al. The predictive value of hierarchical cytogenetic classification in older adults with acute myeloid leukemia (AML); analysis of 10 patients entered into the United Kingdom Medical Research Council AML11 trial. Blood. 2001;98:1312–20.

    CAS  Article  Google Scholar 

  2. 2.

    Hemsing AL, Hovland R, Tsykunova G, Reikvam H. Trisomy 8 in acute myeloid leukemia. Expert Rev Hematol. 2019;12:947–58.

    CAS  Article  PubMed  Google Scholar 

  3. 3.

    Chevallier P, Labopin M, Nagler A, Ljungman P, Verdonck LF, Volin L, et al. Outcome after allogeneic transplantation for adult acute myeloid leukemia patients exhibiting isolated or associated trisomy 8 chromosomal abnormality: a survey on behalf of the ALWP of the EBMT. Bone Marrow Transplant. 2009;44:589–94.

    CAS  Article  PubMed  Google Scholar 

  4. 4.

    Konuma T, Kondo T, Yamashita T, Uchida N, Fukuda T, Ozawa Y, et al. Outcome of allogeneic hematopoietic stem cell transplantation in adult patients with acute myeloid leukemia harboring trisomy 8. Ann Hematol. 2017;96:469–78.

    CAS  Article  PubMed  Google Scholar 

  5. 5.

    Schaich M, Schlenk RF, Al-Ali HK, Dohner H, Ganser A, Heil G, et al. Prognosis of acute myeloid leukemia patients up to 60 years of age exhibiting trisomy 8 within a non-complex karyotype: individual patient data-based meta-analysis of the German Acute Myeloid Leukemia Intergroup. Haematologica. 2007;92:763–70.

    Article  Google Scholar 

  6. 6.

    Weiden PL, Sullivan KM, Flournoy N, Storb R, Thomas ED.and the Seattle Marrow Transplant Team Antileukemic effect of chronic graft-versus-host disease. Contribution to improved survival after allogeneic marrow transplantation. N Engl J Med. 1981;304:1529–33.

    CAS  Article  Google Scholar 

  7. 7.

    Baron F, Maris MB, Sandmaier BM, Storer BE, Sorror M, Diaconescu R, et al. Graft-versus-tumor effects after allogeneic hematopoietic cell transplantation with nonmyeloablative conditioning. J Clin Oncol. 2005;23:1993–2003.

    Article  Google Scholar 

  8. 8.

    Baron F, Labopin M, Niederwieser D, Vigouroux S, Cornelissen JJ, Malm C, et al. Impact of graft-versus-host disease after reduced-intensity conditioning allogeneic stem cell transplantation for acute myeloid leukemia: a report from the Acute Leukemia Working Party of the European group for blood and marrow transplantation. Leukemia. 2012;26:2462–8.

    CAS  Article  Google Scholar 

  9. 9.

    Sloand EM, Kim S, Fuhrer M, Risitano AM, Nakamura R, Maciejewski JP, et al. Fas-mediated apoptosis is important in regulating cell replication and death in trisomy 8 hematopoietic cells but not in cells with other cytogenetic abnormalities. Blood. 2002;100:4427–32.

    CAS  Article  Google Scholar 

  10. 10.

    Dickinson AM, Norden J, Li S, Hromadnikova I, Schmid C, Schmetzer H, et al. Graft-versus-leukemia effect following hematopoietic stem cell transplantation for leukemia. Front Immunol. 2017;8:496

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  11. 11.

    Virtaneva K, Wright FA, Tanner SM, Yuan B, Lemon WJ, Caligiuri MA, et al. Expression profiling reveals fundamental biological differences in acute myeloid leukemia with isolated trisomy 8 and normal cytogenetics. Proc Natl Acad Sci USA. 2001;98:1124–9.

    CAS  Article  PubMed  Google Scholar 

  12. 12.

    Baron F, Ruggeri A, Beohou E, Labopin M, Mohty M, Blaise D, et al. Single- or double-unit UCBT following RIC in adults with AL: a report from Eurocord, the ALWP and the CTIWP of the EBMT. J Hematol Oncol. 2017;10:128

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  13. 13.

    Sengsayadeth S, Gatwood KS, Boumendil A, Labopin M, Finke J, Ganser A, et al. Conditioning intensity in secondary AML with prior myelodysplastic syndrome/myeloproliferative disorders: an EBMT ALWP study. Blood Adv. 2018;2:2127–35.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  14. 14.

    Glucksberg H, Storb R, Fefer A, Buckner CD, Neiman PE, Clift RA, et al. Clinical manifestations of graft-versus-host disease in human recipients of marrow from HL-A-matched sibling donors. Transplantation. 1974;18:295–304.

    CAS  Article  Google Scholar 

  15. 15.

    Andersen PK, Klein JP, Zhang MJ. Testing for centre effects in multi-centre survival studies: a Monte Carlo comparison of fixed and random effects tests. Stat Med. 1999;18:1489–1500.

    CAS  Article  Google Scholar 

  16. 16.

    Chang YJ, Zhao XY, Huang XJ. Strategies for enhancing and preserving anti-leukemia effects without aggravating graft-versus-host disease. Front Immunol. 2018;9:3041

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  17. 17.

    Zittoun R, Suciu S, Watson M, Solbu G, Muus P, Mandelli F, et al. Quality of life in patients with acute myelogenous leukemia in prolonged first complete remission after bone marrow transplantation (allogeneic or autologous) or chemotherapy: a cross-sectional study of the EORTC-GIMEMA AML 8A trial. Bone Marrow Transplant. 1997;20:307–15.

    CAS  Article  Google Scholar 

  18. 18.

    Suciu S, Mandelli F, de Witte T, Zittoun R, Gallo E, Labar B, et al. Allogeneic compared with autologous stem cell transplantation in the treatment of patients younger than 46 years with acute myeloid leukemia (AML) in first complete remission (CR1): an intention-to-treat analysis of the EORTC/GIMEMAAML-10 trial. Blood. 2003;102:1232–40.

    CAS  Article  Google Scholar 

  19. 19.

    Cornelissen JJ, van Putten WL, Verdonck LF, Theobald M, Jacky E, Daenen SM, et al. Results of a HOVON/SAKK donor versus no-donor analysis of myeloablative HLA-identical sibling stem cell transplantation in first remission acute myeloid leukemia in young and middle-aged adults: benefits for whom? Blood. 2007;109:3658–66.

    CAS  Article  Google Scholar 

  20. 20.

    Baron F, Efficace F, Cannella L, Muus P, Trisolini S, Halkes CJM et al. Impact of the type of anthracycline and of stem cell transplantation in younger patients with acute myeloid leukaemia: long-term follow up of a phase III study. Am J Hematol. 2020;95:749–58.

    CAS  Article  PubMed  Google Scholar 

  21. 21.

    Baron F, Efficace F, Cannella L, Willemze R, Vignetti M, Muus P, et al. Long-term follow-up of a trial comparing post-remission treatment with autologous or allogeneic bone marrow transplantation or intensive chemotherapy in younger acute myeloid leukemia patients. Haematologica. 2020;105:e13–e16.

    Article  PubMed  PubMed Central  Google Scholar 

  22. 22.

    Sorror ML, Maris MB, Storb R, Baron F, Sandmaier BM, Maloney DG, et al. Hematopoietic cell transplantation (HCT)-specific comorbidity index: a new tool for risk assessment before allogeneic HCT. Blood. 2005;106:2912–9.

    CAS  Article  Google Scholar 

  23. 23.

    Scott BL, Pasquini MC, Logan BR, Wu J, Devine SM, Porter DL, et al. Myeloablative versus reduced-intensity hematopoietic cell transplantation for acute myeloid leukemia and myelodysplastic syndromes. J Clin Oncol: Off J Am Soc Clin Oncol. 2017;35:1154–61.

    Article  Google Scholar 

  24. 24.

    Baron F, Labopin M, Peniket A, Jindra P, Afanasyev B, Sanz MA, et al. Reduced-intensity conditioning with fludarabine and busulfan versus fludarabine and melphalan for patients with acute myeloid leukemia: a report from the Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation. Cancer. 2015;121:1048–55. e-pub ahead of print 2014/11/27

    CAS  Article  PubMed  Google Scholar 

  25. 25.

    Eapen M, Brazauskas R, Hemmer M, Perez WS, Steinert P, Horowitz MM, et al. Hematopoietic cell transplant for acute myeloid leukemia and myelodysplastic syndrome: conditioning regimen intensity. Blood Adv. 2018;2:2095–103.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

Download references


We thank Emmanuelle Polge and Audrey Mailhol from the office of the ALWP of the EBMT. FB is Senior Research Associate at the National Fund for Scientific Research (FNRS) Belgium. The list of participating centers is provided in the Supplementary Appendix 1.

Author information




FB wrote the paper, designed the study, and interpreted the data; ML designed the study, analyzed and interpreted the data, and edited the paper; AN and MM designed the study, interpreted the data and edited the paper; DB, MIR, GS, EF, IYA, NCG, and JE reviewed the paper and provided clinical data. All authors approved the final version of the paper.

Corresponding author

Correspondence to Frédéric Baron.

Ethics declarations

Conflict of interest

FB has received travel grants and/or speaker honoraria from Celgene, AbbVie, Novartis, Pfizer and Sanofi. The other authors declare that they have no relevant conflict of interest in relation with this study.

Ethical approval

The scientific board of the ALWP of the EBMT approved this study

Informed consent

All patients gave informed consent to participate in retrospective studies

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Baron, F., Labopin, M., Blaise, D. et al. Better leukemia-free survival with allogeneic than with autologous HCT in AML patients with isolated trisomy 8: a study from the ALWP of the EBMT. Bone Marrow Transplant (2020).

Download citation