Transplant Outcomes for Secondary Acute Myeloid Leukemia: Acute Leukemia Working Party of the European Society for Blood and Bone Marrow Transplantation Study.
[en] Secondary acute myeloid leukemia (sAML) has been associated with inferior outcomes compared with de novo AML. Little is known about patient risk factors and outcomes in sAML after allogeneic hematopoietic stem cell transplantation (HCT); thus, this large systemic analysis of the European Society for Blood and Bone Marrow Transplantation registry was performed. This study included 4997 patients with sAML who received HCT from 2000 to 2016. In univariate analysis the 2-year cumulative incidence of chronic graft-versus-host disease (GVHD), relapse, and nonrelapse mortality (NRM) were 33.5% (95% confidence interval [CI], 32% to 34.9%), 33.7% (95% CI, 32.3% to 35.1%), and 27.5% (95% CI, 26.1% to 28.7%), respectively. Overall survival (OS), leukemia-free survival (LFS), and GVHD-free, relapse-free survival (GRFS) at 2 years were 44.5% (95% CI, 43% to 46%), 38.8% (95% CI, 37.4% to 40.3%), and 27.2% (95% CI, 25.9% to 28.6%), respectively. In multivariate analysis, patients receiving myeloablative regimens had decreased relapse (hazard ratio, .859; 95% CI, .761 to .97; P = .01), higher NRM (hazard ratio, 1.175; 95% CI, 1.03 to 1.341; P = .02), and no differences in OS, LFS, and GRFS compared with patients receiving reduced-intensity conditioning regimens. Active disease, adverse cytogenetics, older age, Karnofsky performance status (</=80%), ex vivo T cell depletion, other malignant hematologic diseases, and patient cytomegalovirus seropositivity were associated with inferior OS and LFS. These variables should be considered in patients with sAML in need of HCT, and further study regarding the impact of conditioning regimens on relapse is needed.
Transplant Outcomes for Secondary Acute Myeloid Leukemia: Acute Leukemia Working Party of the European Society for Blood and Bone Marrow Transplantation Study.
Publication date :
2018
Journal title :
Biology of Blood and Marrow Transplantation
ISSN :
1083-8791
eISSN :
1523-6536
Publisher :
Elsevier, Netherlands
Peer reviewed :
Peer Reviewed verified by ORBi
Commentary :
Copyright (c) 2018 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.
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Bibliography
Hulegardh, E., Nilsson, C., Lazarevic, V., et al. Characterization and prognostic features of secondary acute myeloid leukemia in a population-based setting: a report from the Swedish Acute Leukemia Registry. Am J Hematol 90 (2015), 208–214.
Larson, R.A., Is secondary leukemia an independent poor prognostic factor in acute myeloid leukemia?. Best Pract Res Clin Haematol 20 (2007), 29–37.
Ostgard, L.S., Kjeldsen, E., Holm, M.S., et al. Reasons for treating secondary AML as de novo AML. Eur J Haematol 85 (2010), 217–226.
Campo, E., Swerdlow, S.H., Harris, N.L., Pileri, S., Stein, H., Jaffe, E.S., The 2008 WHO classification of lymphoid neoplasms and beyond: evolving concepts and practical applications. Blood 117 (2011), 5019–5032.
Anderson, J.E., Gooley, T.A., Schoch, G., et al. Stem cell transplantation for secondary acute myeloid leukemia: evaluation of transplantation as initial therapy or following induction chemotherapy. Blood 89 (1997), 2578–2585.
Abdelhameed, A., Pond, G.R., Mitsakakis, N., et al. Outcome of patients who develop acute leukemia or myelodysplasia as a second malignancy after solid tumors treated surgically or with strategies that include chemotherapy and/or radiation. Cancer 112 (2008), 1513–1521.
Preiss, B.S., Bergmann, O.J., Friis, L.S., et al. Cytogenetic findings in adult secondary acute myeloid leukemia (AML): frequency of favorable and adverse chromosomal aberrations do not differ from adult de novo AML. Cancer Genet Cytogenet 202 (2010), 108–122.
Kayser, S., Dohner, K., Krauter, J., et al. The impact of therapy-related acute myeloid leukemia (AML) on outcome in 2853 adult patients with newly diagnosed AML. Blood 117 (2011), 2137–2145.
Schoch, C., Kern, W., Schnittger, S., Hiddemann, W., Haferlach, T., Karyotype is an independent prognostic parameter in therapy-related acute myeloid leukemia (t-AML): an analysis of 93 patients with t-AML in comparison to 1091 patients with de novo AML. Leukemia 18 (2004), 120–125.
Miesner, M., Haferlach, C., Bacher, U., et al. Multilineage dysplasia (MLD) in acute myeloid leukemia (AML) correlates with MDS-related cytogenetic abnormalities and a prior history of MDS or MDS/MPN but has no independent prognostic relevance: a comparison of 408 cases classified as “AML not otherwise specified” (AML-NOS) or “AML with myelodysplasia-related changes” (AML-MRC). Blood 116 (2010), 2742–2751.
Larson, R.A., Etiology and management of therapy-related myeloid leukemia. Hematol Am Soc Hematol Educ Progr 2007 (2007), 453–459.
Granfeldt Ostgard, L.S., Medeiros, B.C., Sengelov, H., et al. Epidemiology and clinical significance of secondary and therapy-related acute myeloid leukemia: a national population-based cohort study. J Clin Oncol 33 (2015), 3641–3649.
Wong, T.N., Ramsingh, G., Young, A.L., et al. Role of TP53 mutations in the origin and evolution of therapy-related acute myeloid leukaemia. Nature 518 (2015), 552–555.
Christiansen, D.H., Andersen, M.K., Pedersen-Bjergaard, J., Mutations with loss of heterozygosity of p53 are common in therapy-related myelodysplasia and acute myeloid leukemia after exposure to alkylating agents and significantly associated with deletion or loss of 5q, a complex karyotype, and a poor prognosis. J Clin Oncol 19 (2001), 1405–1413.
Pulsoni, A., Pagano, L., Treatment of secondary acute myeloid leukemia. J Clin Oncol 23 (2005), 926–927.
Rizzieri, D.A., O'Brien, J.A., Broadwater, G., et al. Outcomes of patients who undergo aggressive induction therapy for secondary acute myeloid leukemia. Cancer 115 (2009), 2922–2929.
Stolzel, F., Pfirrmann, M., Aulitzky, W.E., et al. Risk stratification using a new prognostic score for patients with secondary acute myeloid leukemia: results of the prospective AML96 trial. Leukemia 25 (2011), 420–428.
Ostgard, L.S., Norgaard, M., Sengelov, H., et al. Improved outcome in acute myeloid leukemia patients enrolled in clinical trials: a national population-based cohort study of Danish intensive chemotherapy patients. Oncotarget 7 (2016), 72044–72056.
Ornstein, M.C., Mukherjee, S., Mohan, S., et al. Predictive factors for latency period and a prognostic model for survival in patients with therapy-related acute myeloid leukemia. Am J Hematol 89 (2014), 168–173.
Park, S.H., Chi, H.S., Cho, Y.U., Jang, S., Park, C.J., Evaluation of prognostic factors in patients with therapy-related acute myeloid leukemia. Blood Res 48 (2013), 185–192.
Della Porta, M.G., Prognosis of secondary acute myeloid leukemia. Leuk Res 37 (2013), 857–858.
Josting, A., Wiedenmann, S., Franklin, J., et al. Secondary myeloid leukemia and myelodysplastic syndromes in patients treated for Hodgkin's disease: a report from the German Hodgkin's Lymphoma Study Group. J Clin Oncol 21 (2003), 3440–3446.
Dann, E.J., Rowe, J.M., Biology and therapy of secondary leukaemias. Best Pract Res Clin Haematol 14 (2001), 119–137.
Hahn, T., McCarthy, P.L. Jr, Hassebroek, A., et al. Significant improvement in survival after allogeneic hematopoietic cell transplantation during a period of significantly increased use, older recipient age, and use of unrelated donors. J Clin Oncol 31 (2013), 2437–2449.
Bejanyan, N., Weisdorf, D.J., Logan, B.R., et al. Survival of patients with acute myeloid leukemia relapsing after allogeneic hematopoietic cell transplantation: a Center for International Blood and Marrow Transplant Research study. Biol Blood Marrow Transplant 21 (2015), 454–459.
Thanarajasingam, G., Kim, H.T., Cutler, C., et al. Outcome and prognostic factors for patients who relapse after allogeneic hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 19 (2013), 1713–1718.
Bejanyan, N., Oran, B., Shanley, R., et al. Clinical outcomes of AML patients relapsing after matched-related donor and umbilical cord blood transplantation. Bone Marrow Transplant 49 (2014), 1029–1035.
Eapen, M., Giralt, S.A., Horowitz, M.M., et al. Second transplant for acute and chronic leukemia relapsing after first HLA-identical sibling transplant. Bone Marrow Transplant 34 (2004), 721–727.
Oran, B., Giralt, S., Couriel, D., et al. Treatment of AML and MDS relapsing after reduced-intensity conditioning and allogeneic hematopoietic stem cell transplantation. Leukemia 21 (2007), 2540–2544.
Lee, J.H., Lee, K.H., Kim, S., et al. Combination chemotherapy of intermediate-dose cytarabine, idarubicin, plus etoposide and subsequent mobilized donor leukocyte infusion for relapsed acute leukemia after allogeneic bone marrow transplantation. Leuk Res 25 (2001), 305–312.
Bejar, R., Stevenson, K.E., Caughey, B., et al. Somatic mutations predict poor outcome in patients with myelodysplastic syndrome after hematopoietic stem-cell transplantation. J Clin Oncol 32 (2014), 2691–2698.
Della Porta, M.G., Galli, A., Bacigalupo, A., et al. Clinical effects of driver somatic mutations on the outcomes of patients with myelodysplastic syndromes treated with allogeneic hematopoietic stem-cell transplantation. J Clin Oncol 34 (2016), 3627–3637.
Heuser, M., Gabdoulline, R., Loffeld, P., et al. Individual outcome prediction for myelodysplastic syndrome (MDS) and secondary acute myeloid leukemia from MDS after allogeneic hematopoietic cell transplantation. Ann Hematol 96 (2017), 1361–1372.
Michelis, F.V., Atenafu, E.G., Gupta, V., et al. Comparable outcomes post allogeneic hematopoietic cell transplant for patients with de novo or secondary acute myeloid leukemia in first remission. Bone Marrow Transplant 50 (2015), 907–913.
Lee, C.J., Savani, B.N., Mohty, M., et al. Haploidentical hematopoietic cell transplantation for adult acute myeloid leukemia: a position statement from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation. Haematologica 102 (2017), 1810–1822.
Arber, D.A., Orazi, A., Hasserjian, R., et al. The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. Blood 127 (2016), 2391–2405.
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