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  3. Allogeneic Hematopoietic Cell Transplantation in Patients With Acute Myeloid Leukemia With Myelodysplasia-Related Genetic Features: Relevance of the Genetic Underlying Category. A Retrospective Analysis on Behalf of the Acute Leukemia Working Party of the EBMT

Allogeneic Hematopoietic Cell Transplantation in Patients With Acute Myeloid Leukemia With Myelodysplasia-Related Genetic Features: Relevance of the Genetic Underlying Category. A Retrospective Analysis on Behalf of the Acute Leukemia Working Party of the EBMT

Fecha de publicación:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Esteve J.
  • Nagler A.
  • Labopin M.
  • Versluis J.
  • Gedde-Dahl T.
  • Burns D.
  • Roeven M.
  • Labussière-Wallet H.
  • Borne P.V.D.
  • Van Gorkom G.
  • Contentin N.
  • Neubauer A.
  • Wagner-Drouet E.M.
  • Kröger N.
  • Mohty M.
  • Ciceri F.

Grupos

Abstract

Patients (pts) with myelodysplasia-related AML (MR-AML) are now genetically recategorized, with three different groups in the International Consensus Classification: AML with mutated TP53 (TP53-AML), with myelodysplasia-related gene mutations (MR-GM AML), and with myelodysplasia-related cytogenetic abnormalities (MR-CG AML). Moreover, TP53-AML is determined by the presence of an additional complex karyotype (TP53-mut CK and non-CK AML, respectively). Nonetheless, the relevance of this classification to transplantation outcomes is largely unknown. We analyzed the outcomes of pts. with MR-AML undergoing allogeneic hematopoietic cell transplantation in first complete remission between 2010 and 2022 according to these genetic categories. Overall, 1152 patients were identified: 379 (33%), 328 (28%), 246 (21%), and 199 (17%) with MR-GM, TP53-mut CK, MR-CG, and TP53-mut non-CK AML, respectively. Median age was 60 years; median year of transplant was 2020. Unrelated donors and reduced-intensity conditioning were used in 65% and 61% of cases, respectively. Outcomes differed markedly among genetic categories, with an increasing relapse incidence (20.2%, 29.2%, 44.6%, and 57.6% at 2 years), and decreasing LFS (60%, 55.3%, 40.6%, and 20.2% at 2 years), overall survival (65.7%, 60.1%, 47.1%, and 24.5% at 2 years), and graft-versus-host disease-free, relapse-free survival (46.9%, 39.5%, 31.9%, and 13.2% at 2 years) in MR-GM, MR-CG, TP53-mut non-CK, and TP53-mut CK AML, respectively. These differences were confirmed in the multivariate analysis (hazard ratio for LFS: 0.21, 0.33 and 0.61 in MR-GM, MR-CG, and TP53-mut non-CK, with respect to reference TP53-mut CK AML group). This study confirms the strong impact of genetic grouping of MR-AML on transplant outcomes. © 2025 Wiley Periodicals LLC.

Datos de la publicación

ISSN/ISSNe:
0361-8609, 1096-8652

AMERICAN JOURNAL OF HEMATOLOGY  WILEY

Tipo:
Article
Páginas:
954-962
PubMed:
40062532
Enlace a otro recurso:
www.scopus.com
Factor de Impacto:
2,600 SCImago ℠
Cuartil:
Q1 SCImago ℠

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Keywords

  • Adolescent; Adult; Aged; Allografts; Female; Hematopoietic Stem Cell Transplantation; Humans; Leukemia, Myeloid, Acute; Male; Middle Aged; Mutation; Myelodysplastic Syndromes; Retrospective Studies; Transplantation Conditioning; Transplantation, Homologous; Tumor Suppressor Protein p53; Young Adult; protein p53; acute leukemia; acute myeloid leukemia; adult; allogeneic hematopoietic stem cell transplantation; Article; cohort analysis; female; gene mutation; genetic analysis; human; karyotype; male; mortality; myelodysplastic syndrome; recurrence free survival; reduced intensity conditioning; retrospective study; adolescent; aged; allograft; allotransplantation; genetics; hematopoietic stem cell transplantation; middle aged; mutation; therapy; transplantation conditioning; young adult

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