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Haematologica. 2019 Aug 22. pii: haematol.2019.222810. doi: 10.3324/haematol.2019.222810. [Epub ahead of print]

Allogeneic stem cell transplantation in second complete remission for core binding factor acute myeloid leukemia: a study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation.

Author information

1
Institute of Haematology and Transfusion Medicine; khalab30@wp.pl.
2
Hôpital Saint Antoine.
3
EBMT Paris Study Office.
4
Hospital Saint Louis.
5
Queen Elizabeth Hospital, Birmingham.
6
King Faisal Hospital Riyadh, Saudi Arabia.
7
University Hospital, Essen, Germany.
8
Erasmus MC-Daniel den Hoed Cancer Center.
9
Gustave Roussy Institut dr Cancerologie, Villejuif, France.
10
Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Lyon, France.
11
Institut Paoli Calmettes, Marseille, France.
12
Oslo University Hospital, Oslo, Norway.
13
Leeds Teaching Hospitals Trust.
14
CHU de Lille, LIRIC, INSERM U995, Universite' de Lille, France.
15
GKT School of Medicine.
16
Hospital Clinic, Barcelona, Spain.
17
UPMC.
18
Chaim Sheba Madical Center, Tel Hashomer, Israel; EBMT Paris Sudy Office, Paris, France.

Abstract

Core binding factor acute myeloid leukemia comprises two subtypes with distinct cytogenetic abnormalities of either t(8;21)(q22;q22) or inv(16)(p13q22)/t(16;16)(p13;q22). Since long-term response to chemotherapy in those leukemias is relatively good, allogeneic hematopoietic stem cell transplantation is considered in patients who relapse and achieve second complete remission. To evaluate the outcomes of allogeneic transplantation in this indication, we studied 631 patients in reported to the European Society for Blood and Marrow Transplantation Registry between the years 2000 and 2014. Leukemia-free survival probabilities at 2 and 5 years were 59.1% and 54.1%, while overall survival probabilities were 65% and 58.2% respectively. The incidence of relapse and risk of non-relapse mortality at the same time-points were 19.8% and 22.5% for relapse and 20.9% and 23.3% for non-relapse mortality respectively. The most important adverse factors influencing leukemia-free and overall survival were leukemia with t(8;21), presence of 3 or more additional chromosomal abnormalities and Karnofsky performance score <80. Relapse risk was increased in t(8;21) leukemia and associated with additional cytogenetic abnormalities as well as reduced intensity conditioning. Measurable residual disease in molecular evaluation before transplantation was associated with increased risk of relapse and inferior leukemia-free survival.

KEYWORDS:

Acute Myeloid Leukemia; Conditioning Regimen; Stem Cell Transplantation; minimal residual disease

PMID:
31439677
DOI:
10.3324/haematol.2019.222810
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