Hematopoietic Cell Transplantation Outcomes in Monosomal Karyotype Myeloid Malignancies

The presence of monosomal karyotype (MK+) in acute myeloid leukemia (AML) is associated with dismal outcomes. We evaluated the impact of MK+ in AML (MK+AML, n = 240) and in myelodysplastic syndrome (MDS) (MK+MDS, n = 221) on hematopoietic cell transplantation outcomes compared with other cytogenetic...

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Authors: Pasquini, MC, Zhang, MJ, Medeiros, BC, Armand, P, Hui, ZH, Nishihori, T, Aljurf, MD, Akpek, G, Cahn, JY, Cairo, MS, Cerny, J, Copelan, EA, Deol, A, Freytes, CO, Gale, RP, Ganguly, S, George, B, Gupta, V, Hale, GA, Kamble, RT, Klumpp, TR, Lazarus, HM, Luger, SM, Liesveld, JL, Litzow, MR, Marks, DI, Martino, R, Norkin, M, Olsson, RF, Oran, B, Pawarode, A, Pulsipher, MA, Ramanathan, M, Reshef, R, Saad, AA, Saber, W, Savani, BN, Schouten, HC, Ringden, O, Tallman, MS, Uy, GL, Wood, WA, Wirk, B, Perez, WS, Batiwalla, M, Weisdorf, DJ
Format: article
Status:Published version
Publication Date:2016
Country:España
Institution:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repository:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p7617
Online Access:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=7617
Access Level:Open access
Keyword:Monosomal karyotype
Acute myeloid leukemia
Myelodysplastic syndrome
Allogeneic transplantation
Description
Summary:The presence of monosomal karyotype (MK+) in acute myeloid leukemia (AML) is associated with dismal outcomes. We evaluated the impact of MK+ in AML (MK+AML, n = 240) and in myelodysplastic syndrome (MDS) (MK+MDS, n = 221) on hematopoietic cell transplantation outcomes compared with other cytogenetically defined groups (AML, n = 3360; MDS, n = 1373) as reported to the Center for International Blood and Marrow Transplant Research from 1998 to 2011. MK+AML was associated with higher disease relapse (hazard ratio, 1.98; P < .01), similar transplantation-related mortality (TRM) (hazard ratio, 1.01; P = .90), and worse survival (hazard ratio, 1.67; P < .01) compared with those outcomes for other cytogenetically defined AML. Among patients with MDS, MK+ MDS was associated with higher disease relapse (hazard ratio, 2.39; P < .01), higher TRM (hazard ratio, 1.80; P < .01), and worse survival (HR, 2.02; P < .01). Subset analyses comparing chromosome 7 abnormalities (del7/7q) with or without MK+ demonstrated higher mortality for MK+ disease in for both AML (hazard ratio, 1.72; P < .01) and MDS (hazard ratio, 1.79; P < .01). The strong negative impact of MK+ in myeloid malignancies was observed in all age groups and using either myeloablative or reduced-intensity conditioning regimens. Alternative approaches to mitigate disease relapse in this population are needed. (C) 2016 American Society for Blood and Marrow Transplantation.

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