title: Cytogenetics Does Not Impact Outcomes in Adult Patients with Acute Lymphoblastic Leukemia Undergoing Allogeneic Hematopoietic Cell Transplantation.
abstract: The prognostic relevance of cytogenetics at diagnosis on the outcome of allogeneic hematopoietic stem cell transplantation (alloHCT) for adult acute lymphoblastic leukemia (ALL) remains unclear. We retrospectively analyzed outcomes of 333 adult ALL patients who underwent alloHCT at our institution over a 10-year period. Patients were classified according to disease status at transplantation (complete response [CR] 1 [n = 202] or > CR1) and according to cytogenetic risk, defined as good (2%), intermediate (42%), poor (46%), or unknown (10%) based on available outcome data for each of the cytogenetic abnormalities. Three-year overall survival (OS), leukemia-free survival (LFS), and relapse incidence (RI) were 55.7%, 47.9% and 27.5%, respectively; 1-year nonrelapse mortality (NRM) was 17.3%. For patients undergoing alloHCT in CR1, 3-year OS, LFS, and RI were 69.8%, 62.3%, and 17.1%, respectively. In multivariable analysis, cytogenetic risk did not impact OS or LFS for the whole cohort or for patients who underwent transplantation in CR1. Disease status at alloHCT was an independent predictor for LFS (CR1 versus others: hazard ratio [HR], 3.17; P < .01) and OS (CR1 versus others: HR, 2.90; P < .01). Graft-versus-host disease prophylaxis with tacrolimus/sirolimus was associated with a low NRM of 11.5% in the alloHCT recipients in CR1. Our data indicate that cytogenetic risk is not an independent predictor of outcomes in alloHCT performed to treat adult ALL.
authors.affiliation: Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Aldoss
authors.affiliation: Department of Information Sciences, Division of Biostatistics, City of Hope National Medical Center, Duarte, California.
authors.forename: Ni-Chun
authors.initials: NC
authors.lastname: Tsai
authors.affiliation: Palo Verde Laboratory/Sonora Quest Laboratories, Tempe, Arizona.
authors.forename: Marilyn L
authors.initials: ML
authors.lastname: Slovak
authors.affiliation: Department of Information Sciences, Division of Biostatistics, City of Hope National Medical Center, Duarte, California.
authors.forename: Joycelynne
authors.initials: J
authors.lastname: Palmer
authors.affiliation: Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California.
authors.forename: Joseph
authors.initials: J
authors.lastname: Alvarnas
authors.affiliation: Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California.
authors.forename: Guido
authors.initials: G
authors.lastname: Marcucci
authors.affiliation: Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Forman
authors.affiliation: Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California. Electronic address: vpullarkat@coh.org.
authors.forename: Vinod
authors.initials: V
authors.lastname: Pullarkat
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002869:Chromosome Aberrations; D005260:Female; D006086:Graft vs Host Disease / Q000188:drug therapy / Q000517:prevention & control; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis / Q000235:genetics / Q000401:mortality / Q000628:therapy*; D011292:Premedication / Q000379:methods / Q000401:mortality; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D020123:Sirolimus / Q000627:therapeutic use; D016559:Tacrolimus / Q000627:therapeutic use; D014184:Transplantation, Homologous; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D020123:Sirolimus; D016559:Tacrolimus
keywords: Acute lymphoblastic leukemia; Adult; Allogeneic; Cytogenetics; Hematopoietic cell transplantation; Survival