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Predictive significance of the European LeukemiaNet classification of genetic aberrations in patients with acute myeloid leukemia undergoing allogeneic stem cell transplantation

Item Type:Article
Title:Predictive significance of the European LeukemiaNet classification of genetic aberrations in patients with acute myeloid leukemia undergoing allogeneic stem cell transplantation
Creators Name:Hemmati, P.G. and Vuong, L.G. and Terwey, T.H. and Jehn, C.F. and Le Coutre, P. and Penack, O. and Na, I.K. and Dörken, B. and Arnold, R.
Abstract:OBJECTIVES: The purpose of this study was to evaluate the predictive capacity of the European LeukemiaNet (ELN) classification of genetic risk in patients with acute myeloid leukemia (AML) undergoing allogeneic stem cell transplantation (alloSCT). METHODS: We retrospectively analyzed 274 patients transplanted at our center between 2004 and 2014. RESULTS: The ELN grouping is comparable to the Southwest Oncology Group/Eastern Cooperative Oncology Group (SWOG/ECOG) stratification in predicting the outcome after alloSCT (overall p=0.0064 for disease-free survival (DFS), overall p=0.003 for relapse). Patients with an intermediate-1 profile have a significantly elevated 5-year relapse incidence as compared to favorable risk patients i.e. 40% versus 15%, (hazard ratio (HR) 2.58, p=0.048). An intermediate-1 risk profile is an independent predictor for relapse as determined by multivariate Cox regression analysis (HR 3.05, p=0.023). In intermediate-1 patients the presence of an FLT3 internal tandem duplication (FLT3-ITD) is associated with a significantly increased relapse incidence (p=0.0323) and a lower DFS (p=0.0465). FLT3-ITD is an independent predictor for overall survival, DFS, and relapse incidence in the intermediate-1 subgroup. CONCLUSIONS: The ELN stratification of genetic risk predicts the outcome of AML patients undergoing alloSCT. Patients with an intermediate-1 profile have a high risk for treatment failure due to relapse, which prompts the development of alternative treatment strategies.
Keywords:Acute Myeloid Leukemia, Allogeneic Stem Cell Transplantation, Karyotype, European LeukemiaNet, FLT3-ITD
Source:European Journal of Haematology
ISSN:0902-4441
Publisher:Wiley-Blackwell (Denmark)
Volume:98
Number:2
Page Range:160-168
Date:February 2017
Official Publication:https://doi.org/10.1111/ejh.12815
PubMed:View item in PubMed

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