Impact of disease burden on clinical outcomes of AML patients receiving allogeneic hematopoietic cell transplantation: a study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation

Iman Abou Dalle, Myriam Labopin, Nicolaus Kröger, Thomas Schroeder, Jürgen Finke, Matthias Stelljes, Andreas Neubauer, Didier Blaise, Ibrahim Yakoub-Agha, Urpu Salmenniemi, Edouard Forcade, Maija Itäla-Remes, Peter Dreger, Gesine Bug, Jakob Passweg, Michael Heuser, Goda Choi, Eolia Brissot, Sebastian Giebel, Arnon NaglerFabio Ciceri, Ali Bazarbachi*, Mohamad Mohty

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Pre-transplant detectable measurable residual disease (MRD) is still associated with high risk of relapse and poor outcomes in acute myeloid leukemia (AML). We aimed at evaluating the impact of disease burden on prediction of relapse and survival in patients receiving allogeneic hematopoietic cell transplantation (allo-HCT) in first remission (CR1). We identified a total of 3202 adult AML patients, of these 1776 patients were in CR1 and MRD positive and 1426 patients were primary refractory at time of transplant. After a median follow-up of 24.4 months, non-relapse mortality and relapse rate were significantly higher in the primary refractory group compared to the CR1 MRD positive group (Hazards Ratio (HR) = 1.82 (95% CI: 1.47–2.24) p < 0.001 and HR = 1.54 (95% CI: 1.34–1.77), p < 0.001), respectively. Leukemia-free survival (LFS) and overall survival (OS) were significantly worse in the primary refractory group (HR = 1.61 (95% CI: 1.44-1.81), p < 0.001 and HR = 1.71 (95% CI: 1.51–1.94), p < 0.001, respectively). Our real-life data suggest that patients in CR1 and MRD positive at time of transplant could still be salvaged by allo-HCT with a 2-year OS of 63%, if negative MRD cannot be obtained and their outcomes are significantly better than patients transplanted with active disease.

Original languageEnglish
Pages (from-to)784-790
Number of pages7
JournalBone Marrow Transplantation
Volume58
Issue number7
DOIs
StatePublished - Jul 2023
Externally publishedYes

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