Impact of depth of clinical response on outcomes of acute myeloid leukemia patients in first complete remission who undergo allogeneic hematopoietic cell transplantation.

Percival, Mary-Elizabeth; Wang, Hai-Lin; Zhang, Mei-Jie; Saber, Wael; de Lima, Marcos; Litzow, Mark; Kebriaei, Partow; Abdel-Azim, Hisham; Adekola, Kehinde; Aljurf, Mahmoud; Bacher, Ulrike; Badawy, Sherif M; Beitinjaneh, Amer; Bejanyan, Nelli; Bhatt, Vijaya; Byrne, Michael; Cahn, Jean-Yves; Castillo, Paul; Chao, Nelson; Chhabra, Saurabh; ... (2021). Impact of depth of clinical response on outcomes of acute myeloid leukemia patients in first complete remission who undergo allogeneic hematopoietic cell transplantation. (In Press). Bone marrow transplantation Springer Nature 10.1038/s41409-021-01261-6

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Acute myeloid leukemia (AML) patients often undergo allogeneic hematopoietic cell transplantation (alloHCT) in first complete remission (CR). We examined the effect of depth of clinical response, including incomplete count recovery (CRi) and/or measurable residual disease (MRD), in patients from the Center for International Blood and Marrow Transplantation Research (CIBMTR) registry. We identified 2492 adult patients (1799 CR and 693 CRi) who underwent alloHCT between January 1, 2007 and December 31, 2015. The primary outcome was overall survival (OS). Multivariable analysis was performed to adjust for patient-, disease-, and transplant-related factors. Baseline characteristics were similar. Patients in CRi compared to those in CR had an increased likelihood of death (HR: 1.27; 95% confidence interval: 1.13-1.43). Compared to CR, CRi was significantly associated with increased non-relapse mortality (NRM), shorter disease-free survival (DFS), and a trend toward increased relapse. Detectable MRD was associated with shorter OS, shorter DFS, higher NRM, and increased relapse compared to absence of MRD. The deleterious effects of CRi and MRD were independent. In this large CIBMTR cohort, survival outcomes differ among AML patients based on depth of CR and presence of MRD at the time of alloHCT. Further studies should focus on optimizing post-alloHCT outcomes for patients with responses less than CR.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Haematology and Central Haematological Laboratory

UniBE Contributor:

Bacher, Vera Ulrike

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1476-5365

Publisher:

Springer Nature

Language:

English

Submitter:

Pierrette Durand Lüthi

Date Deposited:

27 Apr 2021 15:28

Last Modified:

09 Jun 2021 11:48

Publisher DOI:

10.1038/s41409-021-01261-6

Related URLs:

PubMed ID:

33864019

BORIS DOI:

10.48350/156088

URI:

https://boris.unibe.ch/id/eprint/156088

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