Clonal Hematopoiesis after Autologous Stem Cell Transplantation Does Not Confer Adverse Prognosis in Patients with AML.

Heini, Alexander D.; Porret, Naomi; Zenhaeusern, Reinhard; Winkler, Annette; Bacher, Ulrike; Pabst, Thomas (2021). Clonal Hematopoiesis after Autologous Stem Cell Transplantation Does Not Confer Adverse Prognosis in Patients with AML. Cancers, 13(13) MDPI AG 10.3390/cancers13133190

[img]
Preview
Text
Clonal_Hematopoiesis_after_Autologous.pdf - Published Version
Available under License Creative Commons: Attribution (CC-BY).

Download (448kB) | Preview

INTRODUCTION

Despite a 50% cure rate, relapse remains the main cause of death in patients with acute myeloid leukemia (AML) consolidated with autologous stem cell transplantation (ASCT) in first remission (CR1). Clonal hematopoiesis of indeterminate potential (CH) increases the risk for hematological and cardiovascular disorders and death. The impact of CH persisting after ASCT in AML patients is unclear.

MATERIALS AND METHODS

We retrospectively investigated the prognostic value of persisting DNMT3A, TET2, or ASXL1 (DTA) mutations after ASCT. Patients underwent stratification depending on the presence of DTA mutations.

RESULTS

We investigated 110 consecutive AML patients receiving ASCT in CR1 after two induction cycles at our center between 2007 and 2020. CH-related mutations were present in 31 patients (28.2%) after ASCT. The baseline characteristics were similar between patients with or without persisting DTA mutations after ASCT. The median progression free survival was 26.9 months in patients without DTA mutations and 16.7 months in patients with DTA mutations (HR 0.75 (0.42-1.33), p = 0.287), and the median overall survival was 80.9 and 54.4 months (HR 0.79 (0.41-1.51), p = 0.440), respectively.

CONCLUSION

We suggest that DTA-CH after ASCT is not associated with an increased risk of relapse or death. The persistence of DTA mutations after induction should not prevent AML patients in CR1 from ASCT consolidation. Independent studies should confirm these data.

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

UniBE Contributor:

Heini, Alexander; Porret, Naomi; Bacher, Vera Ulrike and Pabst, Thomas Niklaus

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2072-6694

Publisher:

MDPI AG

Language:

English

Submitter:

Pierrette Durand Lüthi

Date Deposited:

12 Jul 2021 12:29

Last Modified:

12 Jul 2021 12:29

Publisher DOI:

10.3390/cancers13133190

PubMed ID:

34202404

Uncontrolled Keywords:

acute myeloid leukemia (AML) autologous stem cell transplantation (ASCT) clonal hematopoiesis (CH) outcome prognosis

BORIS DOI:

10.48350/157465

URI:

https://boris.unibe.ch/id/eprint/157465

Actions (login required)

Edit item Edit item
Provide Feedback