Genetic risk classification in acute myeloid leukemia patients treated with hematopoietic cell transplantation and post-transplant cyclophosphamide

We analyzed outcomes of 217 AML patients in complete remission who underwent allogeneic HCT with myeloablative conditioning and post-transplant cyclophosphamide-based GVHD prophylaxis, aiming to assess the prognostic significance of genetic risk categories. In the overall cohort, the 2-year overall...

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Autores: Villalba, Marta, Montoro Gómez, Juan, Balaguer-Roselló, Aitana, Chorão, Pedro, Asensi Cantó, Pedro, Granados, Pablo, Gómez-Seguí, Inés, Solves, Pilar, Such, Esperanza, Cervera Mérida, José Francisco, Barragan, Eva, Santiago, Marta, Gil-Orti, José V., Lamas, Brais, Bataller, Ana, Louro, Alberto, de la Rubia Comos, Javier, Sanz, Miguel Á., Sanz, Jaime
Tipo de recurso: artículo
Fecha de publicación:2025
País:España
Institución:Universidad Católica de Valencia San Vicente Mártir
Repositorio:RIUCV. Repositorio de la Universidad Católica de Valencia San Vicente Mártir
Idioma:inglés
OAI Identifier:oai:riucv.ucv.es:20.500.12466/6769
Acceso en línea:https://hdl.handle.net/20.500.12466/6769
Access Level:acceso abierto
Palabra clave:Genetic risk
Patients
Myeloid Leukemia
Hematopoietic cell transplantation
32 Ciencias Médicas
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spelling Genetic risk classification in acute myeloid leukemia patients treated with hematopoietic cell transplantation and post-transplant cyclophosphamideVillalba, MartaMontoro Gómez, JuanBalaguer-Roselló, AitanaChorão, PedroAsensi Cantó, PedroGranados, PabloGómez-Seguí, InésSolves, PilarSuch, EsperanzaCervera Mérida, José FranciscoBarragan, EvaSantiago, MartaGil-Orti, José V.Lamas, BraisBataller, AnaLouro, Albertode la Rubia Comos, JavierSanz, Miguel Á.Sanz, JaimeGenetic riskPatientsMyeloid LeukemiaHematopoietic cell transplantation32 Ciencias MédicasWe analyzed outcomes of 217 AML patients in complete remission who underwent allogeneic HCT with myeloablative conditioning and post-transplant cyclophosphamide-based GVHD prophylaxis, aiming to assess the prognostic significance of genetic risk categories. In the overall cohort, the 2-year overall survival (OS) and event-free survival (EFS) were 77% (95% CI, 71–83) and 72% (95% CI, 66– 78), respectively. ELN2022 risk stratification lacked prognostic value in HCT. Instead, we identified four risk categories with distinct impact on OS: standard risk (ELN2022 favorable/intermediate and adverse-risk without high-risk genetic under the defined subcategories), intermediate risk (≥2 myelodysplasia-related gene mutations) (HR 2.23, 95% CI 1.14-4.92), adverse risk (complex karyotype, monosomal karyotype, inv(3)/t(3;3), KMT2A rearrangement) (hazard ratio (HR) 4.24, 95% CI 2.00 – 9.02), and very adverse risk (TP53 mutations) (HR 6.81, 95% CI 3.00 – 15.5). These categories demonstrated similar predictive power for EFS and cumulative incidence of relapse. Moreover, integrating pre-transplant MRD refined risk stratification, identified MRD- negative patients with ≥2 myelodysplasia-related gene mutations whose OS and EFS were comparable to standard-risk patients. This refined classification improves the prognostic value of ELN2022 for AML patients undergoing allogeneic HCT with modern platform by integrating genetic features and MRD status to better guide post-transplant management.20252025-10-1420252025-09-0120252025-09-01journal articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/20.500.12466/6769reponame:RIUCV. Repositorio de la Universidad Católica de Valencia San Vicente Mártirinstname:Universidad Católica de Valencia San Vicente MártirInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution-NonCommercial 4.0 Internationalhttp://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccessoai:riucv.ucv.es:20.500.12466/67692026-06-19T08:32:07Z
dc.title.none.fl_str_mv Genetic risk classification in acute myeloid leukemia patients treated with hematopoietic cell transplantation and post-transplant cyclophosphamide
title Genetic risk classification in acute myeloid leukemia patients treated with hematopoietic cell transplantation and post-transplant cyclophosphamide
spellingShingle Genetic risk classification in acute myeloid leukemia patients treated with hematopoietic cell transplantation and post-transplant cyclophosphamide
Villalba, Marta
Genetic risk
Patients
Myeloid Leukemia
Hematopoietic cell transplantation
32 Ciencias Médicas
title_short Genetic risk classification in acute myeloid leukemia patients treated with hematopoietic cell transplantation and post-transplant cyclophosphamide
title_full Genetic risk classification in acute myeloid leukemia patients treated with hematopoietic cell transplantation and post-transplant cyclophosphamide
title_fullStr Genetic risk classification in acute myeloid leukemia patients treated with hematopoietic cell transplantation and post-transplant cyclophosphamide
title_full_unstemmed Genetic risk classification in acute myeloid leukemia patients treated with hematopoietic cell transplantation and post-transplant cyclophosphamide
title_sort Genetic risk classification in acute myeloid leukemia patients treated with hematopoietic cell transplantation and post-transplant cyclophosphamide
dc.creator.none.fl_str_mv Villalba, Marta
Montoro Gómez, Juan
Balaguer-Roselló, Aitana
Chorão, Pedro
Asensi Cantó, Pedro
Granados, Pablo
Gómez-Seguí, Inés
Solves, Pilar
Such, Esperanza
Cervera Mérida, José Francisco
Barragan, Eva
Santiago, Marta
Gil-Orti, José V.
Lamas, Brais
Bataller, Ana
Louro, Alberto
de la Rubia Comos, Javier
Sanz, Miguel Á.
Sanz, Jaime
author Villalba, Marta
author_facet Villalba, Marta
Montoro Gómez, Juan
Balaguer-Roselló, Aitana
Chorão, Pedro
Asensi Cantó, Pedro
Granados, Pablo
Gómez-Seguí, Inés
Solves, Pilar
Such, Esperanza
Cervera Mérida, José Francisco
Barragan, Eva
Santiago, Marta
Gil-Orti, José V.
Lamas, Brais
Bataller, Ana
Louro, Alberto
de la Rubia Comos, Javier
Sanz, Miguel Á.
Sanz, Jaime
author_role author
author2 Montoro Gómez, Juan
Balaguer-Roselló, Aitana
Chorão, Pedro
Asensi Cantó, Pedro
Granados, Pablo
Gómez-Seguí, Inés
Solves, Pilar
Such, Esperanza
Cervera Mérida, José Francisco
Barragan, Eva
Santiago, Marta
Gil-Orti, José V.
Lamas, Brais
Bataller, Ana
Louro, Alberto
de la Rubia Comos, Javier
Sanz, Miguel Á.
Sanz, Jaime
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv
dc.subject.none.fl_str_mv Genetic risk
Patients
Myeloid Leukemia
Hematopoietic cell transplantation
32 Ciencias Médicas
topic Genetic risk
Patients
Myeloid Leukemia
Hematopoietic cell transplantation
32 Ciencias Médicas
description We analyzed outcomes of 217 AML patients in complete remission who underwent allogeneic HCT with myeloablative conditioning and post-transplant cyclophosphamide-based GVHD prophylaxis, aiming to assess the prognostic significance of genetic risk categories. In the overall cohort, the 2-year overall survival (OS) and event-free survival (EFS) were 77% (95% CI, 71–83) and 72% (95% CI, 66– 78), respectively. ELN2022 risk stratification lacked prognostic value in HCT. Instead, we identified four risk categories with distinct impact on OS: standard risk (ELN2022 favorable/intermediate and adverse-risk without high-risk genetic under the defined subcategories), intermediate risk (≥2 myelodysplasia-related gene mutations) (HR 2.23, 95% CI 1.14-4.92), adverse risk (complex karyotype, monosomal karyotype, inv(3)/t(3;3), KMT2A rearrangement) (hazard ratio (HR) 4.24, 95% CI 2.00 – 9.02), and very adverse risk (TP53 mutations) (HR 6.81, 95% CI 3.00 – 15.5). These categories demonstrated similar predictive power for EFS and cumulative incidence of relapse. Moreover, integrating pre-transplant MRD refined risk stratification, identified MRD- negative patients with ≥2 myelodysplasia-related gene mutations whose OS and EFS were comparable to standard-risk patients. This refined classification improves the prognostic value of ELN2022 for AML patients undergoing allogeneic HCT with modern platform by integrating genetic features and MRD status to better guide post-transplant management.
publishDate 2025
dc.date.none.fl_str_mv 2025
2025-10-14
2025
2025-09-01
2025
2025-09-01
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/20.500.12466/6769
url https://hdl.handle.net/20.500.12466/6769
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial 4.0 International
http://creativecommons.org/licenses/by-nc/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial 4.0 International
http://creativecommons.org/licenses/by-nc/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:RIUCV. Repositorio de la Universidad Católica de Valencia San Vicente Mártir
instname:Universidad Católica de Valencia San Vicente Mártir
instname_str Universidad Católica de Valencia San Vicente Mártir
reponame_str RIUCV. Repositorio de la Universidad Católica de Valencia San Vicente Mártir
collection RIUCV. Repositorio de la Universidad Católica de Valencia San Vicente Mártir
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.81155

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