title: Significance of persistent cytogenetic abnormalities on myeloablative allogeneic stem cell transplantation in first complete remission.
abstract: Risk stratification is important to identify patients with acute myelogenous leukemia (AML) who might benefit from allogeneic hematopoietic stem cell transplantation (allo-HSCT) in first complete remission. We retrospectively studied 150 patients with AML and diagnostic cytogenetic abnormalities who underwent myeloablative allo-HSCT while in first complete remission to evaluate the prognostic impact of persistent cytogenetic abnormalities at allo-HSCT. Three risk groups were identified. Patients with favorable/intermediate cytogenetics at diagnosis (n = 49) and patients with unfavorable cytogenetics at diagnosis but without a persistent abnormal clone at allo-HSCT (n = 83) had a similar 3-year leukemia-free survival of 58%-60% despite the higher 3-year relapse incidence (RI) in the latter group (32.3%, versus 16.8% in the former group). A third group of patients with unfavorable cytogenetics at diagnosis and a persistent abnormal clone at allo-HSCT (n = 15) had the worst prognosis, with a 3-year RI of 57.5% and 3-year leukemia-free survival of only 29.2%. These data suggest that patients with AML and unfavorable cytogenetics at diagnosis and a persistent abnormal clone at allo-HSCT are at high risk for relapse after allo-HSCT. These patients should be considered for clinical trials designed to optimize conditioning regimens and/or to use preemptive strategies in the posttransplantion setting aimed at decreasing RI.
authors.affiliation: Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030, USA. boran@mdanderson.org
authors.forename: Betul
authors.initials: B
authors.lastname: Oran
authors.forename: Uday
authors.initials: U
authors.lastname: Popat
authors.forename: Gabriella
authors.initials: G
authors.lastname: Rondon
authors.forename: Farhad
authors.initials: F
authors.lastname: Ravandi
authors.forename: Guillermo
authors.initials: G
authors.lastname: Garcia-Manero
authors.forename: Lynn
authors.initials: L
authors.lastname: Abruzzo
authors.forename: Borje S
authors.initials: BS
authors.lastname: Andersson
authors.forename: Qaiser
authors.initials: Q
authors.lastname: Bashir
authors.forename: Julianne
authors.initials: J
authors.lastname: Chen
authors.forename: Partow
authors.initials: P
authors.lastname: Kebriaei
authors.forename: Issa F
authors.initials: IF
authors.lastname: Khouri
authors.forename: Ebru
authors.initials: E
authors.lastname: Koca
authors.forename: Muzaffar H
authors.initials: MH
authors.lastname: Qazilbash
authors.forename: Richard
authors.initials: R
authors.lastname: Champlin
authors.forename: Marcos
authors.initials: M
authors.lastname: de Lima
mesh_terms: D000328:Adult; D002869:Chromosome Aberrations; D018572:Disease-Free Survival; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000235:genetics* / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual / Q000235:genetics / Q000473:pathology; D011379:Prognosis; D012074:Remission Induction; D014184:Transplantation, Homologous