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. - Université de Lille Accéder directement au contenu
Article Dans Une Revue American Journal of Hematology Année : 2018

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.

H Gilleece Maria
  • Fonction : Auteur
Myriam Labopin
  • Fonction : Auteur
Liisa Volin
  • Fonction : Auteur
Gerard Socie
  • Fonction : Auteur
Per Ljungman
  • Fonction : Auteur
Anne Huynh
  • Fonction : Auteur
Depei Wu
  • Fonction : Auteur
Emmanuelle Polge
  • Fonction : Auteur
N Savani Bipin
  • Fonction : Auteur
Arnon Nagler
  • Fonction : Auteur

Résumé

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.

Dates et versions

hal-04426432 , version 1 (30-01-2024)

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Citer

H Gilleece Maria, Myriam Labopin, Ibrahim Yakoub-Agha, Liisa Volin, Gerard Socie, et al.. 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.. American Journal of Hematology, 2018, American Journal of Hematology, 93, pp.1142-1152. ⟨10.1002/ajh.25211⟩. ⟨hal-04426432⟩
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