Transplant Outcomes for Secondary Acute Myeloid Leukemia: Acute Leukemia Working Party of the European Society for Blood and Bone Marrow Transplantation Study

Salyka Sengsayadeth , Myriam Labopin (1, 2) , Ariane Boumendil (3) , Juergen Finke , Arnold Ganser (4) , Matthias Stelljes (5, 5) , Gerhard Ehninger (6) , Dietrich Beelen (7, 8) , Dietger Niederwieser (9) , Didier Blaise (10, 11) , Peter Dreger (12) , Ghulam Mufti (13) , Patrice Chevallier (14) , Audrey Mailhol , Katie S. Gatwood , Norbert Gorin (15) , Jordi Esteve (16) , Fabio Ciceri (17) , Frederic Baron (18) , Christoph Schmid (19) , Sebastian Giebel (20) , Mohamad Mohty , Bipin N. Savani , Arnon Nagler (21)

1 Service d'hématologie clinique et de thérapie cellulaire [CHU Saint-Antoine]
2 CRSA - Centre de Recherche Saint-Antoine
3 Service de Réanimation Médicale [CHU Saint-Antoine]
4 MHH - Hannover Medical School [Hannover]
5 WWU - Westfälische Wilhelms-Universität Münster = University of Münster
6 TU Dresden - Technische Universität Dresden = Dresden University of Technology
7 Dept. of Bone Marrow Transplantation
8 University Hospital Essen
9 Division Hematology, Oncology and Hemostasiology [Leipzig, Germany]
10 Service d’Hématologie [Institut Paoli Calmettes, Marseille]
11 CRCM - Centre de Recherche en Cancérologie de Marseille
12 Department of Medicine V
13 KCH - King's College Hospital
14 Département d'Hématologie [CHU Nantes]
15 IRSN/DRPH/SRBE/LTCRA - Laboratoire de Thérapie Cellulaire et de Radioprotection Accidentelle
16 IDIBAPS - Institut d'Investigacions Biomèdiques August Pi i Sunyer
17 IRCCS Ospedale San Raffaele [Milan, Italy]
18 Université de Liège
19 LMU - Ludwig Maximilian University [Munich]
20 Cancer Center Gliwice
21 UPMC - Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie

Secondary acute myeloid leukemia (sAML) has been associated with inferior outcomes compared with de novo AML. Little is known about patient risk factors and outcomes in sAML after allogeneic hematopoietic stem cell transplantation (HCT); thus, this large systemic analysis of the European Society for Blood and Bone Marrow Transplantation registry was performed. This study included 4997 patients with sAML who received HCT from 2000 to 2016. In univariate analysis the 2-year cumulative incidence of chronic graft-versus-host disease (GVHD), relapse, and nonrelapse mortality (NRM) were 33.5% (95% confidence interval [Cl], 32% to 34.9%), 33.7% (95% CI, 32.3% to 35.1%), and 27.5% (95% CI, 26.1% to 28.7%), respectively. Overall survival (OS), leukemia-free survival (LFS), and GVHD-free, relapse-free survival (GRFS) at 2 years were 44.5% (95% CI, 43% to 46%), 38.8% (95% CI, 37.4% to 40.3%), and 27.2% (95% Cl, 25.9% to 28.6%), respectively. In multivariate analysis, patients receiving myeloablative regimens had decreased relapse (hazard ratio, .859; 95% CI, .761 to .97; P = .01), higher NRM (hazard ratio, 1.175; 95% CI, 1.03 to 1341; P = .02), and no differences in OS, LFS, and GRFS compared with patients receiving reduced-intensity conditioning regimens. Active disease, adverse cytogenetics, older age, Karnofsky performance status (<= 80%), ex vivo T cell depletion, other malignant hematologic diseases, and patient cytomegalovirus seropositivity were associated with inferior OS and LFS. These variables should be considered in patients with sAML in need of HCT, and further study regarding the impact of conditioning regimens on relapse is needed. (C) 2018 American Society for Blood and Marrow Transplantation.

Domains: Life Sciences [q-bio]

Salyka Sengsayadeth, Myriam Labopin, Ariane Boumendil, Juergen Finke, Arnold Ganser, et al.. Transplant Outcomes for Secondary Acute Myeloid Leukemia: Acute Leukemia Working Party of the European Society for Blood and Bone Marrow Transplantation Study. BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION, 2018, 24 (7), pp.1406-1414. ⟨10.1016/j.bbmt.2018.04.008⟩. ⟨hal-02143562⟩