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

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.
Fig. 2

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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.

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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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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 (2020). https://doi.org/10.1038/s41409-020-01051-6

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