Challenging the Adverse Label: Diverse Outcomes of ELN 2022 Adverse Cytogenetic Subgroups in Acute Myeloid Leukemia Patients Allografted in First Remission: From EBMT ALWP. - 2025
Challenging the Adverse Label: Diverse Outcomes of ELN 2022 Adverse Cytogenetic Subgroups in Acute Myeloid Leukemia Patients Allografted in First Remission: From EBMT ALWP.
Bazarbachi, Ali; Galimard, Jacques-Emmanuel; Dalle, Iman Abouet al.
2025 • In American Journal of Hematology, 100 (8), p. 1374 - 1386
[en] According to the European LeukemiaNet (ELN) 2022 classification, acute myeloid leukemia (AML) patients with intermediate or adverse risk are offered allogeneic hematopoietic stem cell transplantation (allo-HSCT) in first remission. In this EBMT study, we included 1735 adult AML patients with ELN-2022 adverse-risk cytogenetics allografted between 2010 and 2022 in first remission (67% de novo AML, median age 56 years). Eleven non-overlapping adverse-risk cytogenetics groups were defined. The five most frequent were: Group 1 [n = 394; monosomy 17 or abn(17p); 2-year leukemia-free survival (LFS) 22%, and overall survival (OS) 25%]; Group 2 [n = 313; complex karyotype (CK) involving monosomy 5, monosomy 7, or del(5q) without monosomy 17 or abn(17p); LFS 27%, OS 37%]; Group 3 [n = 201; monosomy 5, monosomy 7, or del(5q) without CK and without monosomy 17 or abn(17p); LFS: 55%, OS: 63%]; Group 4 [n = 256; CK without monosomal karyotype (MK) or adverse additional cytogenetic abnormalities (ACA); LFS 50%, OS 61%]; Group 5 [n = 213; t(v, 11q23) without adverse ACA; LFS 50%, OS 59%]. In multivariable analysis, compared to CK without adverse ACA, LFS was negatively affected by monosomy 17 or 17p abnormalities, monosomy 5, 7, or del(5q) in the presence of CK, and t(8;16). In conclusion, this study revealed a very poor outcome of allografted AML patients with monosomy 17 or 17p abnormalities or CK involving monosomy 5, monosomy 7, and del5q. Outcomes were relatively favorable for most other ELN 2022 adverse categories, including CK with or without MK other than 5, 7, and 17, indicating that allo-HSCT can overcome their poor outcome.
Disciplines :
Hematology
Author, co-author :
Bazarbachi, Ali ; Bone Marrow Transplantation Program, Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
Galimard, Jacques-Emmanuel; EBMT Paris Study Unit, Sorbonne University, Saint-Antoine Hospital, AP-HP, INSERM UMRs 938, Paris, France
Dalle, Iman Abou ; Bone Marrow Transplantation Program, Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
Socié, Gérard; Saint-Louis Hospital, BMT Unit, Paris, France
Versluis, Jurjen; Erasmus MC Cancer Institute, Rotterdam, the Netherlands
Wu, Depei; First Affiliated Hospital of Soochow University, Suzhou, China
Eder, Matthias; Hannover Medical School, Hannover, Germany
Labussière-Wallet, Hélène; Hôpital Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France
Yakoub-Agha, Ibrahim; CHU de Lille, Lille, France
Maertens, Johan; University Hospital Gasthuisberg, Leuven, Belgium
Forcade, Edouard; CHU Bordeaux, Hôpital Haut-Lévêque, Pessac, France
Gedde-Dahl, Tobias; Oslo University Hospital, Rikshospitalet, Oslo, Norway
Choi, Goda; Dept of Hematology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
Castilla-Llorente, Cristina; Gustave Roussy Cancer Campus, Villejuif, France
Baron, Frédéric ; Université de Liège - ULiège > Département des sciences cliniques
Brissot, Eolia; Service d'hématologie et des maladies du sang, Hôpital Saint-Antoine, Paris, France
Esteve, Jordi ; Department of Hematology, Hospital Clinic, August Pi i Sunyer Biomedical Research Institute, Barcelona, Spain
Nagler, Arnon; Hematology Division, Chaim Sheba Medical Center, Tel-Hashomer, Israel
Challenging the Adverse Label: Diverse Outcomes of ELN 2022 Adverse Cytogenetic Subgroups in Acute Myeloid Leukemia Patients Allografted in First Remission: From EBMT ALWP.
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