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, Eduardo; Martínez-Cuadrón, David; Rodríguez-Veiga, Rebeca; Carrillo-Cruz, Estrella; Gil-Cortés, Cristina; Serrano-López, Josefina; Pérez Simón, José Antonio; Montesinos, Pau

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 enti- ties with distinct mutational landscapes that translate into differential risks of relapse and prognosis. Optimal postremission therapy choice in this heterogeneous patient population is...

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Autores:	Rodríguez-Arbolí, Eduardo, Martínez-Cuadrón, David, Rodríguez-Veiga, Rebeca, Carrillo-Cruz, Estrella, Gil-Cortés, Cristina, Serrano-López, Josefina, Pérez Simón, José Antonio, Montesinos, Pau
Tipo de documento:	artigo
Estado:	Versão publicada
Data de publicação:	2021
País:	España
Recursos:	Universidad de Sevilla (US)
Repositório:	idUS. Depósito de Investigación de la Universidad de Sevilla
OAI Identifier:	oai:idus.us.es:11441/137525
Acesso em linha:	https://hdl.handle.net/11441/137525 https://doi.org/10.1016/j.jtct.2020.12.029
Access Level:	Acceso aberto
Palavra-chave:	Acute myeloid leukemia Allogeneic stem cell transplant Autologous 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 Study.Rodríguez-Arbolí, EduardoMartínez-Cuadrón, DavidRodríguez-Veiga, RebecaCarrillo-Cruz, EstrellaGil-Cortés, CristinaSerrano-López, JosefinaPérez Simón, José AntonioMontesinos, PauAcute myeloid leukemiaAllogeneic stem cell transplantAutologous stem cell transplantAcute myeloid leukemia (AML) with intermediate risk cytogenetics (IRcyto) comprises a variety of biological enti- ties 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 trans- plantation (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 patientsElsevierMedicina2021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttps://hdl.handle.net/11441/137525https://doi.org/10.1016/j.jtct.2020.12.029reponame:idUS. Depósito de Investigación de la Universidad de Sevillainstname:Universidad de Sevilla (US)InglésTransplantation and Cellular Therapy, 27 (4), 311.e1-311.e10.http://europepmc.org/abstract/med/33836871info:eu-repo/semantics/openAccessoai:idus.us.es:11441/1375252026-06-17T12:51:07Z
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, Eduardo Acute myeloid leukemia Allogeneic stem cell transplant Autologous 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, Eduardo Martínez-Cuadrón, David Rodríguez-Veiga, Rebeca Carrillo-Cruz, Estrella Gil-Cortés, Cristina Serrano-López, Josefina Pérez Simón, José Antonio Montesinos, Pau
author	Rodríguez-Arbolí, Eduardo
author_facet	Rodríguez-Arbolí, Eduardo Martínez-Cuadrón, David Rodríguez-Veiga, Rebeca Carrillo-Cruz, Estrella Gil-Cortés, Cristina Serrano-López, Josefina Pérez Simón, José Antonio Montesinos, Pau
author_role	author
author2	Martínez-Cuadrón, David Rodríguez-Veiga, Rebeca Carrillo-Cruz, Estrella Gil-Cortés, Cristina Serrano-López, Josefina Pérez Simón, José Antonio Montesinos, Pau
author2_role	author author author author author author author
dc.contributor.none.fl_str_mv	Medicina
dc.subject.none.fl_str_mv	Acute myeloid leukemia Allogeneic stem cell transplant Autologous stem cell transplant
topic	Acute myeloid leukemia Allogeneic stem cell transplant Autologous stem cell transplant
description	Acute myeloid leukemia (AML) with intermediate risk cytogenetics (IRcyto) comprises a variety of biological enti- ties 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 trans- plantation (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
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://hdl.handle.net/11441/137525 https://doi.org/10.1016/j.jtct.2020.12.029
url	https://hdl.handle.net/11441/137525 https://doi.org/10.1016/j.jtct.2020.12.029
dc.language.none.fl_str_mv	Inglés
language_invalid_str_mv	Inglés
dc.relation.none.fl_str_mv	Transplantation and Cellular Therapy, 27 (4), 311.e1-311.e10. http://europepmc.org/abstract/med/33836871
dc.rights.none.fl_str_mv	info:eu-repo/semantics/openAccess
eu_rights_str_mv	openAccess
dc.format.none.fl_str_mv	application/pdf application/pdf
dc.publisher.none.fl_str_mv	Elsevier
publisher.none.fl_str_mv	Elsevier
dc.source.none.fl_str_mv	reponame:idUS. Depósito de Investigación de la Universidad de Sevilla instname:Universidad de Sevilla (US)
instname_str	Universidad de Sevilla (US)
reponame_str	idUS. Depósito de Investigación de la Universidad de Sevilla
collection	idUS. Depósito de Investigación de la Universidad de Sevilla
repository.name.fl_str_mv
repository.mail.fl_str_mv
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Long-Term Outcomes After Autologous Versus Allogeneic Stem Cell Transplantation in Molecularly-Stratified Patients With Intermediate Cytogenetic Risk Acute Myeloid Leukemia: A PETHEMA Study.

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