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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 Transplantation volume 56, pages 461–469 (2021)Cite this article

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Abstract

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).

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Fig. 1: Relapse and nonrelapse mortality.
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Acknowledgements

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

Authors and Affiliations

  1. Laboratory of Hematology, GIGA-I3, University of Liege and CHU of Liège, Liege, Belgium

    Frédéric Baron

  2. EBMT Paris Study Office/CEREST-TC, Paris, France

    Myriam Labopin, Arnon Nagler & Mohamad Mohty

  3. Department of Haematology, Saint Antoine Hospital, Paris, France

    Myriam Labopin, Norbert Claude Gorin & Mohamad Mohty

  4. INSERM UMR 938, Paris, France

    Myriam Labopin & Mohamad Mohty

  5. Sorbonne University, Paris, France

    Myriam Labopin & Mohamad Mohty

  6. Department of Hematology, Institut Paoli Calmettes, Marseille, France

    Didier Blaise

  7. Stem Cell Transplantation Unit, HUCH Comprehensive Cancer Center, Helsinki, Finland

    Maija Itälä-Remes

  8. Hématologie-Greffe AP-HP Hôpital Saint Louis et Inserm U976, Université de Paris, Paris, France

    Gérard Socié

  9. Service d’Hématologie Clinique et Thérapie Cellulaire, CHU Bordeaux, F-33000, Bordeaux, France

    Edouard Forcade

  10. CHU de Lille, LIRIC, INSERM U995, Université de Lille, 59000, Lille, France

    Ibrahim Yakoub-Agha

  11. Hematology Department, Hospital Clínic de Barcelona, Barcelona, Spain

    Jordi Esteve

  12. Division of Hematology and Bone Marrow Transplantation, Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel

    Arnon Nagler

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  1. Frédéric Baron
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Contributions

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.

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Correspondence to Frédéric Baron.

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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.

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

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All patients gave informed consent to participate in retrospective studies

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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 56, 461–469 (2021). https://doi.org/10.1038/s41409-020-01051-6

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