TY - JOUR
T1 - Age and Modified European LeukemiaNet Classification to Predict Transplant Outcomes
T2 - An Integrated Approach for Acute Myelogenous Leukemia Patients Undergoing Allogeneic Stem Cell Transplantation
AU - Oran, Betül
AU - Jimenez, Antonio M.
AU - De Lima, Marcos
AU - Popat, Uday R.
AU - Bassett, Roland
AU - Andersson, Borje S.
AU - Borthakur, Gautam
AU - Bashir, Qaiser
AU - Chen, Julianne
AU - Ciurea, Stefan O.
AU - Jabbour, Elias
AU - Cortes, Jorge
AU - Kebriaei, Partow
AU - Khouri, Issa F.
AU - Qazilbash, Muzaffar H.
AU - Ravandi, Farhad
AU - Rondon, Gabriela
AU - Lu, Xinyan
AU - Shpall, Elizabeth J.
AU - Champlin, Richard E.
N1 - Funding Information:
Financial disclosure: U.R.P., B.A., and R.E.C. are recipients of research funding from Otsuka Pharmaceuticals .
Publisher Copyright:
© 2015 American Society for Blood and Marrow Transplantation.
PY - 2015/8/1
Y1 - 2015/8/1
N2 - We evaluated the prognostic significance of a modified European LeukemiaNet (ELN) classification for patients with acute myelogenous leukemia (AML) undergoing hematopoietic stem cell transplantation (HSCT) while in first complete remission (CR1). We analyzed 464 AML patients with matched related (n= 211, 45.5%), matched unrelated (n= 176, 37.9%), and mismatched donors (n= 77, 16.6%). Patients were classified into 4 modified ELN risk groups (favorable, intermediate-I, intermediate-II, and adverse) separately for 354 patients age < 60 years and 110 patients age ≥ 60 years. In this modified version of ELN classification, patients with normal cytogenetic were classified by FLT3-ITD mutational status: favorable risk if FLT3-ITDwild and intermediate-I if FLT3-ITDmut. The best outcomes occurred in the ELN favorable and intermediate-II groups in younger AML patients and in the favorable and intermediate-I groups in older AML patients. Older AML patients had worse transplant outcomes within each modified ELN risk group except intermediate-I when compared with younger patients; leukemia-free survival at 3 years was 67.8% versus 49.8% in favorable, 53.4% versus 50.7% in intermediate-I, 65.7% versus 20.2% in intermediate-II, and 44.6% versus 23.8% in adverse group younger and older patients, respectively. Among lesion-specific abnormalities, del5q/-5 and abnl(17p) had the worse transplant outcomes, with 3-year leukemia-free survival rates of 18.4% and 20% in younger CR1 patients. In conclusion, the modified ELN prognostic classification developed for chemotherapy outcomes also identifies prognostic groups for HSCT, which is useful for a selection of patients for post-transplant strategies to improve outcomes.
AB - We evaluated the prognostic significance of a modified European LeukemiaNet (ELN) classification for patients with acute myelogenous leukemia (AML) undergoing hematopoietic stem cell transplantation (HSCT) while in first complete remission (CR1). We analyzed 464 AML patients with matched related (n= 211, 45.5%), matched unrelated (n= 176, 37.9%), and mismatched donors (n= 77, 16.6%). Patients were classified into 4 modified ELN risk groups (favorable, intermediate-I, intermediate-II, and adverse) separately for 354 patients age < 60 years and 110 patients age ≥ 60 years. In this modified version of ELN classification, patients with normal cytogenetic were classified by FLT3-ITD mutational status: favorable risk if FLT3-ITDwild and intermediate-I if FLT3-ITDmut. The best outcomes occurred in the ELN favorable and intermediate-II groups in younger AML patients and in the favorable and intermediate-I groups in older AML patients. Older AML patients had worse transplant outcomes within each modified ELN risk group except intermediate-I when compared with younger patients; leukemia-free survival at 3 years was 67.8% versus 49.8% in favorable, 53.4% versus 50.7% in intermediate-I, 65.7% versus 20.2% in intermediate-II, and 44.6% versus 23.8% in adverse group younger and older patients, respectively. Among lesion-specific abnormalities, del5q/-5 and abnl(17p) had the worse transplant outcomes, with 3-year leukemia-free survival rates of 18.4% and 20% in younger CR1 patients. In conclusion, the modified ELN prognostic classification developed for chemotherapy outcomes also identifies prognostic groups for HSCT, which is useful for a selection of patients for post-transplant strategies to improve outcomes.
KW - AML
KW - Allogeneic stem cell transplantation
KW - European LeukemiaNet
KW - Prognosis
UR - http://www.scopus.com/inward/record.url?scp=84937730288&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84937730288&partnerID=8YFLogxK
U2 - 10.1016/j.bbmt.2015.03.023
DO - 10.1016/j.bbmt.2015.03.023
M3 - Article
C2 - 25840338
AN - SCOPUS:84937730288
SN - 1083-8791
VL - 21
SP - 1405
EP - 1412
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 8
ER -