Tags

Type your tag names separated by a space and hit enter

Allogeneic stem cell transplantation in adult patients with acute myeloid leukaemia and 17p abnormalities in first complete remission: a study from the Acute Leukemia Working Party (ALWP) of the European Society for Blood and Marrow Transplantation (EBMT).
J Hematol Oncol. 2017 01 18; 10(1):20.JH

Abstract

BACKGROUND

Acute myeloid leukaemia (AML) with 17p abnormalities (abn(17p)) carries a very poor prognosis due to high refractoriness to conventional chemotherapy, and allogeneic stem cell transplantation (allo-SCT) appears as the only potential curative option.

METHODS

To address outcomes after allo-SCT in patients with abn(17p), we retrospectively analysed de novo or secondary AML undergoing SCT between 2000 and 2013 from the EBMT registry.

RESULTS

One hundred thirty-nine patients with confirmed abn(17p) have been selected. At the time of transplant, one hundred twenty-five were in first remission (CR1). Median age was 54 years old. Abn(17p) was associated with a monosomal karyotype in 83% of patients, complex karyotype in 91%, monosomy 5 or 5q deletion (-5/5q-) in 55%, monosomy 7 (-7) in 39% and both -5/5q and -7 in 27%. Seventy-three patients (59%) had a reduced-intensity conditioning regimen. The 2-year overall survival (OS) and leukaemia-free survival (LFS) were 28 and 24%, respectively. The 2-year non-relapse mortality (NRM) was 15%, and 2-year relapse incidence (RI) was 61%. The cumulative incidence of grade II to IV acute graft-versus-host disease (GvHD) was 24% and that of chronic GvHD was 21%. In multivariate analysis, the presence of a -5/5q- in addition to abn(17p) was significantly and independently associated with worse OS, LFS and higher RI. Age and donor types did not correlate with outcome. Conditioning intensity was not statistically associated with OS, LFS and NRM when adjusted for patients' age.

CONCLUSIONS

In contrast to the dismal prognosis reported for AML patients harbouring abn(17p) undergoing conventional chemotherapy, allogeneic SCT provides responses in about 25% of those patients transplanted in CR1.

Authors+Show Affiliations

Section of Hematology, Department of Medicine, Cliniques Universitaires Saint-Luc, 10, avenue Hippocrate, 1200, Brussels, Belgium. Xavier.Poire@uclouvain.be.Acute Leukemia Working Party of the EBMT office, Paris, France. Service d'Hématologie clinique, Hôpital Saint-Antoine, AP-HP, Université Pierre et Marie Curie, INSERM UMRs U938, Paris, France.Department of Hematology, University Hospital Gasthuisberg, Leuven, Belgium.UAM allo-CSH, Hôpital HURIEZ, Lille, France.Programme de Transplantation et Thérapie Cellulaire, Centre de Recherche en Cancérologie de Marseille, Institut Paoli Calmettes, Marseille, France.Service des Maladies du Sang, CHRU, Angers, France.Department of Hematology, Hôpital Saint-Louis, Paris, France.Department of Medicine, Rikshospitalet, Oslo, Norway.Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands.Daniel den Hoed Cancer Centre, Erasmus Medical Center, Rotterdam, The Netherlands.Service d'Hématologie, CHU Bordeaux, Pessac, France.Servicio de Hematologia, Hospital Universitario La Fe, Valencia, Spain.Center for Human Genetics, KU Leuven and University Hospitals, Leuven, Belgium.Hematology department, IDIBAPS, Hospital Clinic, Barcelona, Spain.Acute Leukemia Working Party of the EBMT office, Paris, France. Service d'Hématologie clinique, Hôpital Saint-Antoine, AP-HP, Université Pierre et Marie Curie, INSERM UMRs U938, Paris, France.Acute Leukemia Working Party of the EBMT office, Paris, France. Chaim Sheba Medical Center, Tel-Hashomer, Israel.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

28100265

Citation

Poiré, Xavier, et al. "Allogeneic Stem Cell Transplantation in Adult Patients With Acute Myeloid Leukaemia and 17p Abnormalities in First Complete Remission: a Study From the Acute Leukemia Working Party (ALWP) of the European Society for Blood and Marrow Transplantation (EBMT)." Journal of Hematology & Oncology, vol. 10, no. 1, 2017, p. 20.
Poiré X, Labopin M, Maertens J, et al. Allogeneic stem cell transplantation in adult patients with acute myeloid leukaemia and 17p abnormalities in first complete remission: a study from the Acute Leukemia Working Party (ALWP) of the European Society for Blood and Marrow Transplantation (EBMT). J Hematol Oncol. 2017;10(1):20.
Poiré, X., Labopin, M., Maertens, J., Yakoub-Agha, I., Blaise, D., Ifrah, N., Socié, G., Gedde-Dhal, T., Schaap, N., Cornelissen, J. J., Vigouroux, S., Sanz, J., Michaux, L., Esteve, J., Mohty, M., & Nagler, A. (2017). Allogeneic stem cell transplantation in adult patients with acute myeloid leukaemia and 17p abnormalities in first complete remission: a study from the Acute Leukemia Working Party (ALWP) of the European Society for Blood and Marrow Transplantation (EBMT). Journal of Hematology & Oncology, 10(1), 20. https://doi.org/10.1186/s13045-017-0393-3
Poiré X, et al. Allogeneic Stem Cell Transplantation in Adult Patients With Acute Myeloid Leukaemia and 17p Abnormalities in First Complete Remission: a Study From the Acute Leukemia Working Party (ALWP) of the European Society for Blood and Marrow Transplantation (EBMT). J Hematol Oncol. 2017 01 18;10(1):20. PubMed PMID: 28100265.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Allogeneic stem cell transplantation in adult patients with acute myeloid leukaemia and 17p abnormalities in first complete remission: a study from the Acute Leukemia Working Party (ALWP) of the European Society for Blood and Marrow Transplantation (EBMT). AU - Poiré,Xavier, AU - Labopin,Myriam, AU - Maertens,Johan, AU - Yakoub-Agha,Ibrahim, AU - Blaise,Didier, AU - Ifrah,Norbert, AU - Socié,Gérard, AU - Gedde-Dhal,Tobias, AU - Schaap,Nicolaas, AU - Cornelissen,Jan J, AU - Vigouroux,Stéphane, AU - Sanz,Jaime, AU - Michaux,Lucienne, AU - Esteve,Jordi, AU - Mohty,Mohamad, AU - Nagler,Arnon, Y1 - 2017/01/18/ PY - 2016/10/08/received PY - 2017/01/03/accepted PY - 2017/1/20/entrez PY - 2017/1/20/pubmed PY - 2017/12/13/medline KW - 17p abnormalities KW - Acute myeloid leukaemia KW - First remission KW - Stem cell transplantation KW - Survival SP - 20 EP - 20 JF - Journal of hematology & oncology JO - J Hematol Oncol VL - 10 IS - 1 N2 - BACKGROUND: Acute myeloid leukaemia (AML) with 17p abnormalities (abn(17p)) carries a very poor prognosis due to high refractoriness to conventional chemotherapy, and allogeneic stem cell transplantation (allo-SCT) appears as the only potential curative option. METHODS: To address outcomes after allo-SCT in patients with abn(17p), we retrospectively analysed de novo or secondary AML undergoing SCT between 2000 and 2013 from the EBMT registry. RESULTS: One hundred thirty-nine patients with confirmed abn(17p) have been selected. At the time of transplant, one hundred twenty-five were in first remission (CR1). Median age was 54 years old. Abn(17p) was associated with a monosomal karyotype in 83% of patients, complex karyotype in 91%, monosomy 5 or 5q deletion (-5/5q-) in 55%, monosomy 7 (-7) in 39% and both -5/5q and -7 in 27%. Seventy-three patients (59%) had a reduced-intensity conditioning regimen. The 2-year overall survival (OS) and leukaemia-free survival (LFS) were 28 and 24%, respectively. The 2-year non-relapse mortality (NRM) was 15%, and 2-year relapse incidence (RI) was 61%. The cumulative incidence of grade II to IV acute graft-versus-host disease (GvHD) was 24% and that of chronic GvHD was 21%. In multivariate analysis, the presence of a -5/5q- in addition to abn(17p) was significantly and independently associated with worse OS, LFS and higher RI. Age and donor types did not correlate with outcome. Conditioning intensity was not statistically associated with OS, LFS and NRM when adjusted for patients' age. CONCLUSIONS: In contrast to the dismal prognosis reported for AML patients harbouring abn(17p) undergoing conventional chemotherapy, allogeneic SCT provides responses in about 25% of those patients transplanted in CR1. SN - 1756-8722 UR - https://www.unboundmedicine.com/medline/citation/28100265/Allogeneic_stem_cell_transplantation_in_adult_patients_with_acute_myeloid_leukaemia_and_17p_abnormalities_in_first_complete_remission:_a_study_from_the_Acute_Leukemia_Working_Party__ALWP__of_the_European_Society_for_Blood_and_Marrow_Transplantation__EBMT__ L2 - https://jhoonline.biomedcentral.com/articles/10.1186/s13045-017-0393-3 DB - PRIME DP - Unbound Medicine ER -