Hematopoietic Cell Transplantation Outcomes in Monosomal Karyotype Myeloid Malignancies.
The presence of monosomal karyotype (MK+) in acute myeloid leukemia (AML) is associated with dismal outcomes. We evaluated the impact of MK+ in AML (MK+AML, n = 240) and in myelodysplastic syndrome (MDS) (MK+MDS, n = 221) on hematopoietic cell transplantation outcomes compared with other cytogenetically defined groups (AML, n = 3360; MDS, n = 1373) as reported to the Center for International Blood and Marrow Transplant Research from 1998 to 2011. MK+ AML was associated with higher disease relapse (hazard ratio, 1.98; P < .01), similar transplantation-related mortality (TRM) (hazard ratio, 1.01; P = .90), and worse survival (hazard ratio, 1.67; P < .01) compared with those outcomes for other cytogenetically defined AML. Among patients with MDS, MK+ MDS was associated with higher disease relapse (hazard ratio, 2.39; P < .01), higher TRM (hazard ratio, 1.80; P < .01), and worse survival (HR, 2.02; P < .01). Subset analyses comparing chromosome 7 abnormalities (del7/7q) with or without MK+ demonstrated higher mortality for MK+ disease in for both AML (hazard ratio, 1.72; P < .01) and MDS (hazard ratio, 1.79; P < .01). The strong negative impact of MK+ in myeloid malignancies was observed in all age groups and using either myeloablative or reduced-intensity conditioning regimens. Alternative approaches to mitigate disease relapse in this population are needed.
Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin. Electronic address: mpasquini@mcw.edu.
Marcelo C
MC
Pasquini
Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, Wisconsin.
Mei-Jie
MJ
Zhang
Department of Hematology, Stanford University School of Medicine, Stanford, California.
Bruno C
BC
Medeiros
Department of Medical Oncology/Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, Massachusetts.
Philippe
P
Armand
Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
Zhen-Huan
ZH
Hu
Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.
Taiga
T
Nishihori
Department of Oncology, King Faisal Specialist Hospital Center and Research, Riyadh, Saudi Arabia.
Mahmoud D
MD
Aljurf
Stem Cell Transplantation and Cellular Therapy Program, Banner MD Anderson Cancer Center, Gilbert, Arizona.
Görgün
G
Akpek
Department of Hematology, University Hospital, Grenoble, France.
Jean-Yves
JY
Cahn
Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Department of Pediatrics, New York Medical College, Valhalla, New York.
Mitchell S
MS
Cairo
Department of Medicine, UMass Memorial Medical Center, Worcester, Massachusetts.
Jan
J
Cerny
Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Carolinas HealthCare System, Charlotte, North Carolina.
Edward A
EA
Copelan
Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, Michigan.
Abhinav
A
Deol
Division of Hematology & Oncology, South Texas Veterans Health Care System and University of Texas Health Science Center San Antonio, San Antonio, Texas.
César O
CO
Freytes
Hematology Research Centre, Division of Experimental Medicine, Department of Medicine, Imperial College London, London, United Kingdom.
Robert Peter
RP
Gale
Blood and Marrow Transplantation, Division of Hematology and Oncology, University of Kansas Medical Center, Kansas City, Kansas.
Siddhartha
S
Ganguly
Department of Haematology, Christian Medical College, Vellore, India.
Biju
B
George
Blood and Marrow Transplant Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.
Vikas
V
Gupta
Department of Hematology/Oncology, All Children's Hospital, St. Petersburg, Florida.
Gregory A
GA
Hale
Division of Hematology and Oncology, Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, Texas.
Rammurti T
RT
Kamble
Department of Medical Oncology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
Thomas R
TR
Klumpp
Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland, Ohio.
Hillard M
HM
Lazarus
Department of Medicine, Abramson Cancer Center, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania.
Selina M
SM
Luger
Department of Medicine, University of Rochester Medical Center, Rochester, New York.
Jane L
JL
Liesveld
Division of Hematology and Transplant Center, Mayo Clinic, Rochester, Minnesota.
Mark R
MR
Litzow
Pediatric Bone Marrow Transplant, University Hospitals Bristol NHS Trust, Bristol, United Kingdom.
David I
DI
Marks
Division of Clinical Hematology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Rodrigo
R
Martino
Division of Hematology/Oncology, University of Florida College of Medicine, Gainesville, Florida.
Maxim
M
Norkin
Division of Therapeutic Immunology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Clinical Research Sörmland, Uppsala University, Uppsala, Sweden.
Richard F
RF
Olsson
Division of Cancer Medicine, Department of Stem Cell Transplantation, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Betul
B
Oran
Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan.
Attaphol
A
Pawarode
Division of Hematology, Oncology, and Blood and Marrow Transplantation, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, California.
Michael A
MA
Pulsipher
Department of Medicine, UMass Memorial Medical Center, Worcester, Massachusetts.
Muthalagu
M
Ramanathan
Department of Medicine, Abramson Cancer Center, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania.
Ran
R
Reshef
Division of Hematology/Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.
Ayman A
AA
Saad
Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
Wael
W
Saber
Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
Bipin N
BN
Savani
Department of Hematology, Academische Ziekenhuis, Maastricht, Netherlands.
Harry C
HC
Schouten
Division of Therapeutic Immunology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Allogeneic Stem Cell Transplantation, Stockholm, Sweden.
Olle
O
Ringdén
Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
Martin S
MS
Tallman
Division of Oncology, Washington University School of Medicine, St. Louis, Missouri.
Geoffrey L
GL
Uy
Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, North Carolina.
William A
WA
Wood
Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, Washington.
Baldeep
B
Wirk
Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
Waleska S
WS
Pérez
Hematology Branch, National Heart Lung and Blood Institute - National Institutes of Health, Bethesda, Maryland.
Minoo
M
Batiwalla
Division of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota Medical Center, Minneapolis, Minnesota.
Daniel J
DJ
Weisdorf
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D007223:Infant; D059785:Karyotype; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000401:mortality / Q000628:therapy*; D019172:Transplantation Conditioning / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
Acute myeloid leukemia; Allogeneic transplantation; Monosomal karyotype; Myelodysplastic syndrome