Long-Term Outcomes After Autologous Versus Allogeneic Stem Cell Transplantation in Molecularly-Stratified Patients With Intermediate Cytogenetic Risk Acute Myeloid Leukemia: A PETHEMA Study

Acute myeloid leukemia (AML) with intermediate risk cytogenetics (IRcyto) comprises a variety of biological entities with distinct mutational landscapes that translate into differential risks of relapse and prognosis. Optimal postremission therapy choice in this heterogeneous patient population is c...

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Autores: Rodríguez-Arbolí E, Martínez-Cuadrón D, Rodríguez-Veiga R, Carrillo-Cruz E, Gil-Cortés C, Serrano-López J, Bernal Del Castillo T, Martínez-Sánchez MDP, Rodríguez-Medina C, Vidriales B, Bergua JM, Benavente C, García-Boyero R, Herrera-Puente P, Algarra L, Sayas-Lloris MJ, Fernández R, Labrador J, Lavilla-Rubira E, Barrios-García M, Tormo M, Serrano-Maestro A, Sossa-Melo CL, García-Belmonte D, Vives S, Rodríguez-Gutiérrez JI, Albo-López C, Garrastazul-Sánchez MP, Colorado-Araujo M, Mariz J, Sanz MÁ, Pérez-Simón JA, Montesinos P, PETHEMA (Programa Español de Tratamientos en Hematología) and GETH (Grupo Españo
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repositorio:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p9370
Acceso en línea:https://fisabio.portalinvestigacion.com/publicaciones/9370
Access Level:acceso abierto
Palabra clave:Acute myeloid leukemia
Autologous stem cell transplant
Allogeneic stem cell transplant
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spelling Long-Term Outcomes After Autologous Versus Allogeneic Stem Cell Transplantation in Molecularly-Stratified Patients With Intermediate Cytogenetic Risk Acute Myeloid Leukemia: A PETHEMA StudyRodríguez-Arbolí EMartínez-Cuadrón DRodríguez-Veiga RCarrillo-Cruz EGil-Cortés CSerrano-López JBernal Del Castillo TMartínez-Sánchez MDPRodríguez-Medina CVidriales BBergua JMBenavente CGarcía-Boyero RHerrera-Puente PAlgarra LSayas-Lloris MJFernández RLabrador JLavilla-Rubira EBarrios-García MTormo MSerrano-Maestro ASossa-Melo CLGarcía-Belmonte DVives SRodríguez-Gutiérrez JIAlbo-López CGarrastazul-Sánchez MPColorado-Araujo MMariz JSanz MÁPérez-Simón JAMontesinos PPETHEMA (Programa Español de Tratamientos en Hematología) and GETH (Grupo EspañoAcute myeloid leukemiaAutologous stem cell transplantAllogeneic stem cell transplantAcute myeloid leukemia (AML) with intermediate risk cytogenetics (IRcyto) comprises a variety of biological entities with distinct mutational landscapes that translate into differential risks of relapse and prognosis. Optimal postremission therapy choice in this heterogeneous patient population is currently unsettled. In the current study, we compared outcomes in IRcyto AML recipients of autologous (autoSCT) (n = 312) or allogeneic stem cell transplantation (alloSCT) (n = 279) in first complete remission (CR1). Molecular risk was defined based on CEBPA, NPM1, and FLT3-ITD mutational status, per European LeukemiaNet 2017 criteria. Five-year overall survival (OS) in patients with favorable molecular risk (FRmol) was 62% (95% confidence interval [CI], 50-72) after autoSCT and 66% (95% CI, 41-83) after matched sibling donor (MSD) alloSCT (P=.68). For patients of intermediate molecular risk (IRmol), MSD alloSCT was associated with lower cumulative incidence of relapse (P<.001), as well as with increased nonrelapse mortality (P=.01), as compared to autoSCT. The 5-year OS was 47% (95% CI, 34-58) after autoSCT and 70% (95% CI, 59-79) after MSD alloSCT (P=.02) in this patient subgroup. In a propensity-score matched IRmol subcohort (n = 106), MSD alloSCT was associated with superior leukemia-free survival (hazard ratio [HR] 0.33, P=.004) and increased OS in patients alive 1 year after transplantation (HR 0.20, P=.004). These results indicate that, within IRcyto AML in CR1, autoSCT may be a valid option for FRmol patients, whereas MSD alloSCT should be the preferred postremission strategy in IRmol patients. (C) 2021 The American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved.ELSEVIER SCIENCE INC2021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fisabio.portalinvestigacion.com/publicaciones/9370Transplantation and Cellular TherapyISSN: 26666375ISSNe: 26666367reponame:r-FISABIO. Repositorio Institucional de Producción Científicainstname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)Inglésinfo:eu-repo/semantics/openAccessoai:fisabio.fundanetsuite.com:p93702026-06-11T12:45:17Z
dc.title.none.fl_str_mv Long-Term Outcomes After Autologous Versus Allogeneic Stem Cell Transplantation in Molecularly-Stratified Patients With Intermediate Cytogenetic Risk Acute Myeloid Leukemia: A PETHEMA Study
title Long-Term Outcomes After Autologous Versus Allogeneic Stem Cell Transplantation in Molecularly-Stratified Patients With Intermediate Cytogenetic Risk Acute Myeloid Leukemia: A PETHEMA Study
spellingShingle Long-Term Outcomes After Autologous Versus Allogeneic Stem Cell Transplantation in Molecularly-Stratified Patients With Intermediate Cytogenetic Risk Acute Myeloid Leukemia: A PETHEMA Study
Rodríguez-Arbolí E
Acute myeloid leukemia
Autologous stem cell transplant
Allogeneic stem cell transplant
title_short Long-Term Outcomes After Autologous Versus Allogeneic Stem Cell Transplantation in Molecularly-Stratified Patients With Intermediate Cytogenetic Risk Acute Myeloid Leukemia: A PETHEMA Study
title_full Long-Term Outcomes After Autologous Versus Allogeneic Stem Cell Transplantation in Molecularly-Stratified Patients With Intermediate Cytogenetic Risk Acute Myeloid Leukemia: A PETHEMA Study
title_fullStr Long-Term Outcomes After Autologous Versus Allogeneic Stem Cell Transplantation in Molecularly-Stratified Patients With Intermediate Cytogenetic Risk Acute Myeloid Leukemia: A PETHEMA Study
title_full_unstemmed Long-Term Outcomes After Autologous Versus Allogeneic Stem Cell Transplantation in Molecularly-Stratified Patients With Intermediate Cytogenetic Risk Acute Myeloid Leukemia: A PETHEMA Study
title_sort Long-Term Outcomes After Autologous Versus Allogeneic Stem Cell Transplantation in Molecularly-Stratified Patients With Intermediate Cytogenetic Risk Acute Myeloid Leukemia: A PETHEMA Study
dc.creator.none.fl_str_mv Rodríguez-Arbolí E
Martínez-Cuadrón D
Rodríguez-Veiga R
Carrillo-Cruz E
Gil-Cortés C
Serrano-López J
Bernal Del Castillo T
Martínez-Sánchez MDP
Rodríguez-Medina C
Vidriales B
Bergua JM
Benavente C
García-Boyero R
Herrera-Puente P
Algarra L
Sayas-Lloris MJ
Fernández R
Labrador J
Lavilla-Rubira E
Barrios-García M
Tormo M
Serrano-Maestro A
Sossa-Melo CL
García-Belmonte D
Vives S
Rodríguez-Gutiérrez JI
Albo-López C
Garrastazul-Sánchez MP
Colorado-Araujo M
Mariz J
Sanz MÁ
Pérez-Simón JA
Montesinos P
PETHEMA (Programa Español de Tratamientos en Hematología) and GETH (Grupo Españo
author Rodríguez-Arbolí E
author_facet Rodríguez-Arbolí E
Martínez-Cuadrón D
Rodríguez-Veiga R
Carrillo-Cruz E
Gil-Cortés C
Serrano-López J
Bernal Del Castillo T
Martínez-Sánchez MDP
Rodríguez-Medina C
Vidriales B
Bergua JM
Benavente C
García-Boyero R
Herrera-Puente P
Algarra L
Sayas-Lloris MJ
Fernández R
Labrador J
Lavilla-Rubira E
Barrios-García M
Tormo M
Serrano-Maestro A
Sossa-Melo CL
García-Belmonte D
Vives S
Rodríguez-Gutiérrez JI
Albo-López C
Garrastazul-Sánchez MP
Colorado-Araujo M
Mariz J
Sanz MÁ
Pérez-Simón JA
Montesinos P
PETHEMA (Programa Español de Tratamientos en Hematología) and GETH (Grupo Españo
author_role author
author2 Martínez-Cuadrón D
Rodríguez-Veiga R
Carrillo-Cruz E
Gil-Cortés C
Serrano-López J
Bernal Del Castillo T
Martínez-Sánchez MDP
Rodríguez-Medina C
Vidriales B
Bergua JM
Benavente C
García-Boyero R
Herrera-Puente P
Algarra L
Sayas-Lloris MJ
Fernández R
Labrador J
Lavilla-Rubira E
Barrios-García M
Tormo M
Serrano-Maestro A
Sossa-Melo CL
García-Belmonte D
Vives S
Rodríguez-Gutiérrez JI
Albo-López C
Garrastazul-Sánchez MP
Colorado-Araujo M
Mariz J
Sanz MÁ
Pérez-Simón JA
Montesinos P
PETHEMA (Programa Español de Tratamientos en Hematología) and GETH (Grupo Españo
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Acute myeloid leukemia
Autologous stem cell transplant
Allogeneic stem cell transplant
topic Acute myeloid leukemia
Autologous stem cell transplant
Allogeneic stem cell transplant
description Acute myeloid leukemia (AML) with intermediate risk cytogenetics (IRcyto) comprises a variety of biological entities with distinct mutational landscapes that translate into differential risks of relapse and prognosis. Optimal postremission therapy choice in this heterogeneous patient population is currently unsettled. In the current study, we compared outcomes in IRcyto AML recipients of autologous (autoSCT) (n = 312) or allogeneic stem cell transplantation (alloSCT) (n = 279) in first complete remission (CR1). Molecular risk was defined based on CEBPA, NPM1, and FLT3-ITD mutational status, per European LeukemiaNet 2017 criteria. Five-year overall survival (OS) in patients with favorable molecular risk (FRmol) was 62% (95% confidence interval [CI], 50-72) after autoSCT and 66% (95% CI, 41-83) after matched sibling donor (MSD) alloSCT (P=.68). For patients of intermediate molecular risk (IRmol), MSD alloSCT was associated with lower cumulative incidence of relapse (P<.001), as well as with increased nonrelapse mortality (P=.01), as compared to autoSCT. The 5-year OS was 47% (95% CI, 34-58) after autoSCT and 70% (95% CI, 59-79) after MSD alloSCT (P=.02) in this patient subgroup. In a propensity-score matched IRmol subcohort (n = 106), MSD alloSCT was associated with superior leukemia-free survival (hazard ratio [HR] 0.33, P=.004) and increased OS in patients alive 1 year after transplantation (HR 0.20, P=.004). These results indicate that, within IRcyto AML in CR1, autoSCT may be a valid option for FRmol patients, whereas MSD alloSCT should be the preferred postremission strategy in IRmol patients. (C) 2021 The American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved.
publishDate 2021
dc.date.none.fl_str_mv 2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fisabio.portalinvestigacion.com/publicaciones/9370
url https://fisabio.portalinvestigacion.com/publicaciones/9370
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv ELSEVIER SCIENCE INC
publisher.none.fl_str_mv ELSEVIER SCIENCE INC
dc.source.none.fl_str_mv Transplantation and Cellular Therapy
ISSN: 26666375
ISSNe: 26666367
reponame:r-FISABIO. Repositorio Institucional de Producción Científica
instname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
instname_str Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
reponame_str r-FISABIO. Repositorio Institucional de Producción Científica
collection r-FISABIO. Repositorio Institucional de Producción Científica
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.81155

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