title: Impact of cytogenetics risk on outcome after reduced intensity conditioning allo-SCT from an HLA-identical sibling for patients with AML in first CR: a report from the acute leukemia working party of EBMT.
abstract: So far the impact of cytogenetics risk on outcome in the context of reduced intensity conditioning (RIC) allo-SCT has been poorly studied. We have identified 378 AML patients in first CR who underwent RIC allo-SCT from an HLA-matched sibling donor between 2000 and 2007 reported to the European Group for Bone and Marrow Transplantation and for whom detailed cytogenetics data were available (good risk: n=21; intermediate risk: n=304; and poor risk: n=53). With a median follow-up of 24 months (range: 1-93), 2-year non-relapse mortality, relapse rate (RR), leukemia-free survival (LFS) and OS were 14%, 31%, 55% and 61%, respectively. Cytogenetics was significantly associated with RR (good risk: 10%; intermediate risk: 28%; and poor risk: 55% at 2 years, P<0.0001) and LFS (good risk: 64%; intermediate risk: 57%; and poor risk: 38% at 2 years, P=0.003). In a multivariate analysis, RR and LFS were significantly higher and lower, respectively, in the high-risk cytogenetics group (P=0.001, P=0.004) and in patients with a higher WBC at diagnosis (>10 × 10(9)/L) (P<0.001, P=0.004). As documented in the setting of myeloablative allo-SCT, patients with poor cytogenetics had increased RR and decreased LFS after RIC allo-SCT, requiring new prospective strategies to improve results in this subgroup.
authors.affiliation: Department of Haematology, Centre Hospitalier Universitaire (CHU) Hôtel-Dieu, Nantes, France. patrice.chevallier@chu-nantes.fr
authors.forename: P
authors.initials: P
authors.lastname: Chevallier
authors.forename: M
authors.initials: M
authors.lastname: Labopin
authors.forename: N
authors.initials: N
authors.lastname: Milpied
authors.forename: J J
authors.initials: JJ
authors.lastname: Cornelissen
authors.forename: D
authors.initials: D
authors.lastname: Blaise
authors.forename: E
authors.initials: E
authors.lastname: Petersen
authors.forename: A
authors.initials: A
authors.lastname: Sandstedt
authors.forename: H
authors.initials: H
authors.lastname: Goker
authors.forename: G
authors.initials: G
authors.lastname: Socie
authors.forename: V
authors.initials: V
authors.lastname: Rocha
authors.forename: M
authors.initials: M
authors.lastname: Mohty
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003582:Cytogenetics; D005260:Female; D006680:HLA Antigens / Q000235:genetics / Q000276:immunology*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000235:genetics* / Q000601:surgery*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D035781:Siblings; D019172:Transplantation Conditioning / Q000379:methods*; D055815:Young Adult
chemical_list: D006680:HLA Antigens