title: Impact of FAB classification on predicting outcome in acute myeloid leukemia, not otherwise specified, patients undergoing allogeneic stem cell transplantation in CR1: An analysis of 1690 patients from the acute leukemia working party of EBMT.
abstract: The French, American, and British (FAB) classification system for acute myeloid leukemia (AML) is extensively used and is incorporated into the AML, not otherwise specified (NOS) category in the 2016 WHO edition of myeloid neoplasm classification. While recent data proposes that FAB classification does not provide additional prognostic information for patients for whom NPM1 status is available, it is unknown whether FAB still retains a current prognostic role in predicting outcome of AML patients undergoing allogeneic stem cell transplantation. Using the European Society of Blood and Bone Marrow Transplantation registry we analyzed outcome of 1690 patients transplanted in CR1 to determine if FAB classification provides additional prognostic value. Multivariate analysis revealed that M6/M7 patients had decreased leukemia free survival (hazard ratio (HR) of 1.41, 95% confidence interval (CI), 1.01-1.99; P = .046) in addition to increased nonrelapse mortality (NRM) rates (HR, 1.79; 95% CI, 1.06-3.01; P = .028) compared with other FAB types. In the NPM1wtAML, NOS cohort, FAB M6/M7 was also associated with increased NRM (HR, 2.17; 95% CI, 1.14-4.16; P = .019). Finally, in FLT3-ITD+patients, multivariate analyses revealed that specific FAB types were tightly associated with adverse outcome. In conclusion, FAB classification may predict outcome following transplantation in AML, NOS patients.
authors.affiliation: Hematology Division, Chaim Sheba Medical Center, Tel Hashomer, Tel Aviv University, Israel.
authors.forename: Jonathan
authors.identifier: http://orcid.org/0000-0002-5294-3524
authors.initials: J
authors.lastname: Canaani
authors.affiliation: Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, Universite Pierre & Marie Curie, Paris, France.|EBMT Acute Leukemia Working Party office, Hôpital Saint-Antoine, Paris, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Beohou
authors.affiliation: Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, Universite Pierre & Marie Curie, Paris, France.|EBMT Acute Leukemia Working Party office, Hôpital Saint-Antoine, Paris, France.
authors.forename: Myriam
authors.initials: M
authors.lastname: Labopin
authors.affiliation: EBMT Acute Leukemia Working Party office, Hôpital Saint-Antoine, Paris, France.
authors.forename: Gerard
authors.initials: G
authors.lastname: Socié
authors.affiliation: Institut Universitaire du Cancer Toulouse, Oncopole, Toulouse, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Huynh
authors.affiliation: HUCH Comprehensive Cancer Center, Stem Cell Transplantation Unit, Helsinki, Finland.
authors.forename: Liisa
authors.initials: L
authors.lastname: Volin
authors.affiliation: Department of Hematology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Jan
authors.initials: J
authors.lastname: Cornelissen
authors.affiliation: CHU Bordeaux, Hôpital Haut-leveque, Pessac, France.
authors.forename: Noel
authors.initials: N
authors.lastname: Milpied
authors.affiliation: Department of Hematology, Clinic for Cancer, Surgery and Transplantation, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
authors.forename: Tobias
authors.initials: T
authors.lastname: Gedde-Dahl
authors.affiliation: Service d`Hématologie, Hopital Jean Minjoz, Besancon, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Deconinck
authors.affiliation: Département d`Hématologie Clinique, CHU Lapeyronie, Montpellier, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Fegueux
authors.affiliation: Centre de Recherche en Cancérologie de Marseille, Programme de Transplantation & Therapie Cellulaire, Marseille, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Blaise
authors.affiliation: Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, Universite Pierre & Marie Curie, Paris, France.
authors.forename: Mohamad
authors.initials: M
authors.lastname: Mohty
authors.affiliation: Hematology Division, Chaim Sheba Medical Center, Tel Hashomer, Tel Aviv University, Israel.|EBMT Acute Leukemia Working Party office, Hôpital Saint-Antoine, Paris, France.
authors.forename: Arnon
authors.initials: A
authors.lastname: Nagler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002965:Classification; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000145:classification* / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D000090243:Nucleophosmin; D011379:Prognosis; D012074:Remission Induction; D033581:Stem Cell Transplantation / Q000379:methods / Q000401:mortality; D014184:Transplantation, Homologous; D055815:Young Adult