Title :

Measurable residual disease, conditioning regimen intensity and age predict outcome of allogeneic hematopoietic cell transplantation for acute myeloid leukemia in first remission: a registry analysis of 2292 patients by the Acute Leukemia Working Party European Society of Blood and Marrow Transplantation.

Author(s) :

Gilleece Maria, H [Auteur]
Labopin, Myriam [Auteur]
Yakoub Agha, Ibrahim [Auteur]
Lille Inflammation Research International Center (LIRIC) - U995
Volin, Liisa [Auteur]
Socie, Gerard [Auteur]
Ljungman, Per [Auteur]
Huynh, Anne [Auteur]
Deconinck, Eric [Auteur]
Wu, Depei [Auteur]
Bourhis, Jean-Henri [Auteur]
Cahn, Jean-Yves [Auteur]
Polge, Emmanuelle [Auteur]
Mohty, Mohamad [Auteur]
Savani Bipin, N [Auteur]
Nagler, Arnon [Auteur]

Journal title :

American journal of hematology

Abbreviated title :

Am. J. Hematol.

Publication date :

2018-07-07

ISSN :

1096-8652

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Patients with acute myeloid leukemia (AML) in morphological first complete remission (CR1) pre-allogeneic hematopoietic cell transplantation (HCT) may have measurable residual disease (MRD) by molecular and immunophenotyping ...
Show more >Patients with acute myeloid leukemia (AML) in morphological first complete remission (CR1) pre-allogeneic hematopoietic cell transplantation (HCT) may have measurable residual disease (MRD) by molecular and immunophenotyping criteria. We assessed interactions of MRD status with HCT conditioning regimen intensity in patients aged <50 years (y) or >/=50y. This was a retrospective study by the European Society for Blood and Marrow Transplantation registry. Patients were >18y with AML CR1 MRD NEG/POS and recipients of HCT in 2000-2015. Conditioning regimens were myeloablative (MAC), reduced intensity (RIC) or non-myeloablative (NMA). Outcomes included leukemia free survival (LFS), overall survival (OS), relapse incidence (RI), non-relapse mortality (NRM), chronic graft-vs-host (cGVHD), and GVHD-free and relapse-free survival (GRFS). The 2292 eligible patients were categorized into four paired groups: <50y MRD POS MAC (N = 240) vs RIC/NMA (N = 58); <50y MRD NEG MAC (N = 665) vs RIC/NMA (N = 195); >/=50y MRD POS MAC (N = 126) vs RIC/NMA (N = 230), and >/=50y MRD NEG MAC (N = 223) vs RIC/NMA (N = 555). In multivariate analysis RIC/NMA was only inferior to MAC for patients in the <50y MRD POS group, with worse RI (HR 1.71) and LFS (HR 1.554). Patients <50Y MRD NEG had less cGVHD after RIC/NMA HCT (HR 0.714). GRFS was not significantly affected by conditioning intensity in any group. Patients aged <50y with AML CR1 MRD POS status should preferentially be offered MAC allo-HCT. Prospective studies are needed to address whether patients with AML CR1 MRD NEG may be spared the toxicity of MAC regimens. New approaches are needed for >/=50y AML CR1 MRD POS.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Inserm
Université de Lille
CHU Lille

Collections :

• Lille Inflammation Research International Center (LIRIC) - U995

Research team(s) :

Immunity, inflammation and fibrsis in auto and allo-reactivity

Submission date :

2019-03-01T14:17:45Z