Complex karyotype but not other cytogenetic abnormalities is associated with worse posttransplant survival of patients with nucleophosmin 1-mutated acute myeloid leukemia: A study from the European Society for Blood and Marrow Transplantation Acute Leukemia Working Party
Standard
Complex karyotype but not other cytogenetic abnormalities is associated with worse posttransplant survival of patients with nucleophosmin 1-mutated acute myeloid leukemia: A study from the European Society for Blood and Marrow Transplantation Acute Leukemia Working Party. / Moukalled, Nour; Labopin, Myriam; Versluis, Jurjen; Socié, Gérard; Blaise, Didier; Salmenniemi, Urpu; Rambaldi, Alessandro; Gedde-Dahl, Tobias; Tholouli, Eleni; Kröger, Nicolaus; Bourhis, Jean-Henri; Von Dem Borne, Peter; Daguindau, Etienne; Forcade, Edouard; Nagler, Arnon; Esteve, Jordi; Ciceri, Fabio; Bazarbachi, Ali; Mohty, Mohamad.
In: AM J HEMATOL, Vol. 99, No. 3, 03.2024, p. 360-369.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Complex karyotype but not other cytogenetic abnormalities is associated with worse posttransplant survival of patients with nucleophosmin 1-mutated acute myeloid leukemia: A study from the European Society for Blood and Marrow Transplantation Acute Leukemia Working Party
AU - Moukalled, Nour
AU - Labopin, Myriam
AU - Versluis, Jurjen
AU - Socié, Gérard
AU - Blaise, Didier
AU - Salmenniemi, Urpu
AU - Rambaldi, Alessandro
AU - Gedde-Dahl, Tobias
AU - Tholouli, Eleni
AU - Kröger, Nicolaus
AU - Bourhis, Jean-Henri
AU - Von Dem Borne, Peter
AU - Daguindau, Etienne
AU - Forcade, Edouard
AU - Nagler, Arnon
AU - Esteve, Jordi
AU - Ciceri, Fabio
AU - Bazarbachi, Ali
AU - Mohty, Mohamad
N1 - © 2024 Wiley Periodicals LLC.
PY - 2024/3
Y1 - 2024/3
N2 - In the 2022 European LeukemiaNet classification, patients with nucleophosmin 1 (NPM1)-mutated acute myeloid leukemia (AML) were classified in the adverse-risk category in the presence of high-risk cytogenetics (CG). Nonetheless, the impact of various CG aberrations on posttransplant outcomes remains to be unraveled. This registry study analyzed adult patients with NPM1-mutated de novo AML who underwent their first allogeneic hematopoietic cell transplantation in the first complete remission from 2005 to 2021. A total of 3275 patients were identified, 2782 had normal karyotype, 493 had chromosomal aberrations including 160 with adverse-risk CG, 72 patients had complex karyotype (CK), and 66 monosomal karyotype (MK). Overall, 2377 (73%) patients had FLT3-ITD. On univariate analysis, only FLT3-ITD, minimal/measurable residual disease (MRD) positivity and CK, but not abnormal CG, affected posttransplant outcomes. On multivariable analysis, CK was associated with lower overall survival (OS) (hazard ratio [HR] 1.72, p = .009). In the subgroup of 493 patients with aberrant CG, the 2-year leukemia-free survival (LFS) and OS were around 61% and 68%, respectively. On multivariable analysis for this subgroup, CK and MRD positivity were associated with increased risk of relapse (HR 1.7, p = .025; and 1.99, p = .003 respectively) and worse LFS (HR 1.62, p = .018; and 1.64, p = .011 respectively) while FLT3-ITD, MK, or other CG abnormalities had no significant effect. Importantly, CK negatively affected OS (HR 1.91, p = .002). In the first complete remission transplant setting, CK was found as the only cytogenetic risk factor for worse outcomes in NPM1-mutated AML. Nevertheless, even for this subgroup, a significant proportion of patients can achieve long-term posttransplant survival.
AB - In the 2022 European LeukemiaNet classification, patients with nucleophosmin 1 (NPM1)-mutated acute myeloid leukemia (AML) were classified in the adverse-risk category in the presence of high-risk cytogenetics (CG). Nonetheless, the impact of various CG aberrations on posttransplant outcomes remains to be unraveled. This registry study analyzed adult patients with NPM1-mutated de novo AML who underwent their first allogeneic hematopoietic cell transplantation in the first complete remission from 2005 to 2021. A total of 3275 patients were identified, 2782 had normal karyotype, 493 had chromosomal aberrations including 160 with adverse-risk CG, 72 patients had complex karyotype (CK), and 66 monosomal karyotype (MK). Overall, 2377 (73%) patients had FLT3-ITD. On univariate analysis, only FLT3-ITD, minimal/measurable residual disease (MRD) positivity and CK, but not abnormal CG, affected posttransplant outcomes. On multivariable analysis, CK was associated with lower overall survival (OS) (hazard ratio [HR] 1.72, p = .009). In the subgroup of 493 patients with aberrant CG, the 2-year leukemia-free survival (LFS) and OS were around 61% and 68%, respectively. On multivariable analysis for this subgroup, CK and MRD positivity were associated with increased risk of relapse (HR 1.7, p = .025; and 1.99, p = .003 respectively) and worse LFS (HR 1.62, p = .018; and 1.64, p = .011 respectively) while FLT3-ITD, MK, or other CG abnormalities had no significant effect. Importantly, CK negatively affected OS (HR 1.91, p = .002). In the first complete remission transplant setting, CK was found as the only cytogenetic risk factor for worse outcomes in NPM1-mutated AML. Nevertheless, even for this subgroup, a significant proportion of patients can achieve long-term posttransplant survival.
KW - Adult
KW - Humans
KW - Nucleophosmin
KW - Bone Marrow
KW - Mutation
KW - Chromosome Aberrations
KW - Leukemia, Myeloid, Acute/genetics
KW - Hematopoietic Stem Cell Transplantation
KW - Abnormal Karyotype
KW - Karyotype
KW - Neoplasm, Residual
KW - Prognosis
KW - fms-Like Tyrosine Kinase 3/genetics
KW - Retrospective Studies
U2 - 10.1002/ajh.27187
DO - 10.1002/ajh.27187
M3 - SCORING: Journal article
C2 - 38165072
VL - 99
SP - 360
EP - 369
JO - AM J HEMATOL
JF - AM J HEMATOL
SN - 0361-8609
IS - 3
ER -
