In adults with t(8;21)AML, posttransplant RUNX1/RUNX1T1-based MRD monitoring, rather than c-KIT mutations, allows further risk stratification

Abstract

Key Points• RUNX1/RUNX1T1-based MRD status at 1, 2, and 3 months after HSCT could discriminate patients at high risk of post-HSCT relapse.• Rather than c-KIT mutations, MRD monitoring allows further rapid identification of patients at high risk of relapse after allo-HSCT.We asked whether minimal residual disease (MRD) determined by RUNX1/RUNX1T1 transcript levels could identify allogeneic hematopoietic stem cell transplantation (allo-HSCT) t(8;21) (q22;q22) acute myeloid leukemia patients who are at high risk for relapse, together with the impact of c-KIT mutations. Ninety-two consecutive adult t(8;21) patients who received allo-HSCT in complete remission were enrolled. MRD status at 1, 2, and 3 months after HSCT identified relapse patients (P 5 .05, P < .001, P 5 .0001, respectively). The 2-year cumulative incidence of relapse (CIR) and leukemia-free survival (LFS) was 32% vs 9% (P 5 .01) and 55% vs 70% (P 5 .12) for patients with and without c-KIT mutations, respectively. In multivariate analysis, MRD at the first 3 months after HSCT, rather than c-KIT mutations, was an independent factor for CIR (P 5 .001) and LFS (P 5 .001).In addition, 17 patients received donor lymphocyte infusion (DLI) as interventional therapy for MRD, and the 2-year CIR and LFS for patients with or without DLI was 24% vs 87% (P 5 .001) and 64% vs 0% (P < .001), respectively. In conclusion, MRD monitoring early after transplant allows further rapid identification of t(8;21) patients at high risk of relapse and was more predictive of relapse risk than

The bone marrow microenvironment is similarly impaired in allogeneic hematopoietic stem cell transplantation patients with early and late poor graft function

“…Complete donor chimerism was defined as no recipient hematopoietic or lymphoid cells detected; the sensitivity of these methods enables the detection of as low as 0.1% of recipient signals. 17 Diagnoses were categorized as standard or high risk. Standard risk was defined as first or second CR (CR1 or CR2) of acute leukemia or myelodysplastic syndrome.…”

“…2,[17][18][19] The patients were screened pre-transplant for CMV infection by serology. Weekly real-time quantitative PCR was used to detect CMV reactivation in blood samples.…”

Atorvastatin enhances endothelial cell function in posttransplant poor graft function

“…Complete donor chimerism was defined as the detection of no recipient hematopoietic or lymphoid cells (sensitivity .0.1% recipient signals). 26 …”

Risk factors for relapse after allogeneic transplantation in acute myeloid leukemia

“…36 The clinical impact of expression levels of numerous other genes such as BAALC, ERG, MN1 etc., still has to be determined. How these new molecular aberrancies could be integrated Table 2.…”