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Outcome and risk fa...
Outcome and risk factor analysis of molecular subgroups in cytogenetically normal AML treated by allogeneic transplantation.
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Schmid, Christoph (author)
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Labopin, Myriam (author)
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Socié, Gerard (author)
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Daguindau, Etienne (author)
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Volin, Liisa (author)
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Huynh, Anne (author)
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Bourhis, Jean Henri (author)
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Milpied, Noel (author)
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Cornelissen, Jan (author)
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Chevallier, Patrice (author)
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Maertens, Johan (author)
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Jindra, Pavel (author)
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Blaise, Didier (author)
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- Lenhoff, Stig (author)
- Lund University,Lunds universitet,Avdelningen för hematologi och transfusionsmedicin,Institutionen för laboratoriemedicin,Medicinska fakulteten,Division of Hematology and Transfusion Medicine,Department of Laboratory Medicine,Faculty of Medicine
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Ifrah, Norbert (author)
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Baron, Frédéric (author)
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Ciceri, Fabio (author)
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Gorin, Claude (author)
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Savani, Bipin (author)
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Giebel, Sebastian (author)
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Polge, Emmanuelle (author)
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Esteve, Jordi (author)
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Nagler, Arnon (author)
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Mohty, Mohamad (author)
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(creator_code:org_t)
- American Society of Hematology, 2015
- 2015
- English.
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In: Blood. - : American Society of Hematology. - 1528-0020 .- 0006-4971. ; 126:17, s. 2062-2069
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http://www.ncbi.nlm....
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http://dx.doi.org/10...
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
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- Patients with cytogenetically normal acute myeloid leukemia (CN-AML) can be subdivided by molecular mutations. However, data on the influence of combinations of different aberrations on outcome after allogeneic hematopoietic stem cell transplantation (HSCT) is limited. Therefore, we performed a retrospective registry analysis on 702 adults with CN-AML undergoing HSCT in first complete remission (CR). Patients were grouped according to presence or absence of NPM1 mutations (NPM1(mut)) and FLT3 internal tandem duplications (FLT3-ITD). Double negative patients were evaluated for mutations of the CCAAT/enhancer binding protein α gene (CEBPα). The influence of genotypes on relapse, non-relapse mortality, leukemia-free survival (LFS) and overall survival (OS), and a prognostic classification combining NPM1/FLT3-ITD profile and classical risk factors were calculated. 2y-OS from HSCT was 81±5% in NPM1(mut)/FLT3(wt) (n=68), 75±3% in NPM1(wt)/FLT3(wt) (n=290), 66±3% in NPM1(mut)/FLT3-ITD (n=269) and 54±7% in NPM1(wt)/FLT3-ITD (n=75; p=0.003). Analysis of CEBPα among patients with NPM1(wt)/FLT3(wt) revealed excellent results both in patients with CEBPα(mut) (n=13, 2y-OS:100%), and with a triple negative genotype (n=138, 2y-OS:77±3%). In a Cox-model of predefined factors, older age, presence of FLT3-ITD and >1 course of chemotherapy to reach CR were associated with inferior outcome. 2y-OS/LFS were 88±3%/79±4% in patients without any, 77±2%/73±3% with one, and 53±4%/50±4 with>=2 risk factors (p=0.002 for LFS, p=0.003 for OS). Hence, FLT3-ITD proofed to be the decisive molecular marker for outcome after HSCT for CN-AML in CR1, regardless of NPM1 mutational status, variations of transplant protocols, or development of GvHD. Age, FLT3-ITD and response to induction chemotherapy allow for a prognostic risk classification.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Hematologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Hematology (hsv//eng)
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- art (subject category)
- ref (subject category)
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Blood
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- By the author/editor
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Schmid, Christop ...
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Labopin, Myriam
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Socié, Gerard
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Daguindau, Etien ...
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Volin, Liisa
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Huynh, Anne
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show more...
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Bourhis, Jean He ...
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Milpied, Noel
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Cornelissen, Jan
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Chevallier, Patr ...
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Maertens, Johan
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Jindra, Pavel
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Blaise, Didier
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Lenhoff, Stig
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Ifrah, Norbert
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Baron, Frédéric
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Ciceri, Fabio
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Gorin, Claude
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Savani, Bipin
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Giebel, Sebastia ...
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Polge, Emmanuell ...
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Esteve, Jordi
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Nagler, Arnon
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Mohty, Mohamad
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Hematology
- Articles in the publication
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Blood
- By the university
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Lund University