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Risk classification at diagnosis predicts post-HCT outcomes in intermediate-, adverse-risk, and KMT2A-rearranged AML
- Source :
- Blood Advances. 6:828-847
- Publication Year :
- 2022
- Publisher :
- American Society of Hematology, 2022.
-
Abstract
- Little is known about whether risk classification at diagnosis predicts post-hematopoietic cell transplantation (HCT) outcomes in patients with acute myeloid leukemia (AML). We evaluated 8709 patients with AML from the CIBMTR database, and after selection and manual curation of the cytogenetics data, 3779 patients in first complete remission were included in the final analysis: 2384 with intermediate-risk, 969 with adverse-risk, and 426 with KMT2A-rearranged disease. An adjusted multivariable analysis detected an increased risk of relapse for patients with KMT2A-rearranged or adverse-risk AML as compared to those with intermediate-risk disease (hazards ratio [HR], 1.27; P = .01; HR, 1.71; P < .001, respectively). Leukemia-free survival was similar for patients with KMT2A rearrangement or adverse risk (HR, 1.26; P = .002, and HR, 1.47; P < .001), as was overall survival (HR, 1.32; P < .001, and HR, 1.45; P < .001). No differences in outcome were detected when patients were stratified by KMT2A fusion partner. This study is the largest conducted to date on post-HCT outcomes in AML, with manually curated cytogenetics used for risk stratification. Our work demonstrates that risk classification at diagnosis remains predictive of post-HCT outcomes in AML. It also highlights the critical need to develop novel treatment strategies for patients with KMT2A-rearranged and adverse-risk disease.
- Subjects :
- Oncology
medicine.medical_specialty
biology
business.industry
Remission Induction
Hematopoietic Stem Cell Transplantation
Cytogenetics
Myeloid leukemia
Hematology
Disease
Leukemia, Myeloid, Acute
Increased risk
KMT2A
Cell transplantation
Recurrence
hemic and lymphatic diseases
Internal medicine
Overall survival
medicine
biology.protein
Humans
610 Medicine & health
Risk classification
business
Subjects
Details
- ISSN :
- 24739537 and 24739529
- Volume :
- 6
- Database :
- OpenAIRE
- Journal :
- Blood Advances
- Accession number :
- edsair.doi.dedup.....21257a5f341df64c6305ea812a34ea30