Myeloid Leukemia with Myelodysplasia-Related Changes Was Not a Prognostic Factor Under Allogenic Hematopoietic Stem Cell Transplantation

Lee, Yoonha; Ichiki, Tomoe; Okabe, Motohito; Kawaguchi, Yuka; Ohbiki, Marie; Osaki, Masahide; Goto, Miyo; Sato, Takahiko; Araie, Hiroaki; Goto, Tatsunori; Morishita, Takanobu; Ozawa, Yukiyasu; Miyamura, Koichi

doi:10.1016/j.bbmt.2018.12.394

Cited by 2 publications

(6 citation statements)

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“…Despite this, there is further evidence showing a benefit of achieving CR status prior to HSCT in s-AML patients. 9,16,23,31,32 In our experience, s-AML patients in CR before HSCT had better outcomes compared to those with AD before HSCT (2y-EFS 34.0% vs. 0.0%, p = 0.007 and 2y-OS 40.0% vs.…”

Section: Univariate Analysis For Efsmentioning

confidence: 70%

“…Regarding transplant characteristics, a higher percentage of s‐AML patients had AD before HSCT (22.4% vs. 9.6%, p = 0.032), they received RIC regimen (46.5% vs. 25%, p = 0.034), and had an haploidentical or unrelated donor (82.8% vs. 55.8%, p = 0.006) more frequently (Table 1). The median follow‐up of the global cohort, s‐AML and de novo groups were 12 [5–38] months (m), 9 4–25 m and 18 [6–45] m respectively.…”

Section: Resultsmentioning

confidence: 99%

“…Some studies suggest that HSCT could overcome the poor prognosis of s-AML. 6,8,9 Alternatively, other reports suggest that the s-AML group continues to have inferior survival compared to de novo AML in other reports. 10,11 This may be due to the previously mentioned factors most commonly seen in s-AML, as adverse cytogenetic or molecular profile, complex karyotype or TP53 mutation, or disease status before HSCT, which are also associated with to worse survival after HSCT.…”

Section: Aml With Myelodysplasia Related Changes Therapy Related Aml ...mentioning

confidence: 97%

“…However, the results comparing to de novo AML patients in the context of HSCT are not uniform. Some studies suggest that HSCT could overcome the poor prognosis of s‐AML 6,8,9 . Alternatively, other reports suggest that the s‐AML group continues to have inferior survival compared to de novo AML in other reports 10,11 .…”

Section: Introductionmentioning

confidence: 99%

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Patients with secondary acute myeloid leukemia undergoing allogeneic stem‐cell transplant have inferior outcomes than de novo acute myeloid leukemia regardless minimal residual disease level by flow cytometry

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Chillón

Martin‐Moro

et al. 2023

Hematological Oncology

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Secondary acute myeloid leukemia (s‐AML) patients have a poor prognosis and currently the only curative therapy is allogeneic stem‐cell transplant (HSCT). However, we do not yet know whether transplantation is sufficient to reverse the poor prognosis compared to de novo AML patients. We analyzed survival after HSCT comparing a cohort of 58 patients with s‐AML versus 52 de novo patients who were transplanted between 2012 and 2020. Patients with s‐AML had worse event‐free survival (EFS) (p = 0.001) and overall survival (OS) (p < 0.001) compared to de novo AML due to an increased risk of relapse (p = 0.06) and non‐relapse mortality (p = 0.03). The main difference in survival was observed in patients who achieved complete remission (CR) before HSCT (EFS p = 0.002 OS and <0.001), regardless minimal residual disease (MRD) by |multiparametric flow cytometry cohorts. In patients transplanted with active disease (AD), the prognosis was adverse in both s‐AML and de novo AML groups (EFS p = 0.869 and OS p = 0.930). After excluding patients with AD, we stratified the cohort according to conditioning intensity, noticing that s‐AML who received MAC had comparable outcomes to de novo AML, but the survival differences remained among reduce intensity conditioning group. In conclusion, transplanted s‐AML patients have worse survival among patients in CR before HSCT, regardless of MRD level by flow cytometry compared to de novo AML. MAC patients had similar outcomes irrespective of leukemia ontogeny.

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Section: Univariate Analysis For Efsmentioning

confidence: 70%

Section: Resultsmentioning

confidence: 99%

Section: Aml With Myelodysplasia Related Changes Therapy Related Aml ...mentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Patients with secondary acute myeloid leukemia undergoing allogeneic stem‐cell transplant have inferior outcomes than de novo acute myeloid leukemia regardless minimal residual disease level by flow cytometry

Stock

Chillón

Martin‐Moro

et al. 2023

Hematological Oncology

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“…AML-MRC was not an independent prognostic factor for poor outcomes after alloHSCT in multivariate analysis (p = 0.7). A second study by Lee et al of 138 patients showed similar results with no significant difference in 3-year OS (41% vs. 57%), CIR (35% vs. 21%), and NRM (24% vs. 22%) between patients with and without AML-MRC following alloHSCT [46]. Again, multivariate analysis did not find AML-MRC to be an independent prognostic factor (p = 0.40) after alloHSCT.…”

Section: Allogenic Hematopoietic Stem Cell Transplant (Allohsct)mentioning

confidence: 74%

AML with Myelodysplasia-Related Changes: Development, Challenges, and Treatment Advances

Koenig

Sahasrabudhe

Sigmund

et al. 2020

Genes

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Acute myeloid leukemia (AML) with myelodysplasia-related changes (AML-MRC) is a distinct biologic subtype of AML that represents 25–34% of all AML diagnoses and associates with especially inferior outcomes compared to non-MRC AML. Typically, patients with AML-MRC experience low remission rates following intensive chemotherapy and a median overall survival of merely 9–12 months. In light of these discouraging outcomes, it has become evident that more effective therapies are needed for patients with AML-MRC. Liposomal daunorubicin–cytarabine (CPX-351) was approved in 2017 for adults with newly diagnosed AML-MRC and those with therapy-related AML (t-AML), and remains the only therapy specifically approved for this patient population. Other studies have also demonstrated the efficacy of the hypomethylating agent (HMA) azacitidine as upfront therapy for AML-MRC patients, which, to date, is the most common treatment employed for patients unable to tolerate the more intensive CPX-351. HMAs and venetoclax combinations have also been evaluated, but additional studies utilizing these agents in this specific subgroup are needed before conclusions regarding their role in the therapeutic armamentarium of AML-MRC patients can be reached. Currently, many studies are ongoing in attempts to further improve outcomes in this historically ill-fated patient group.

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Myeloid Leukemia with Myelodysplasia-Related Changes Was Not a Prognostic Factor Under Allogenic Hematopoietic Stem Cell Transplantation

Cited by 2 publications

References 0 publications

Patients with secondary acute myeloid leukemia undergoing allogeneic stem‐cell transplant have inferior outcomes than de novo acute myeloid leukemia regardless minimal residual disease level by flow cytometry

Patients with secondary acute myeloid leukemia undergoing allogeneic stem‐cell transplant have inferior outcomes than de novo acute myeloid leukemia regardless minimal residual disease level by flow cytometry

AML with Myelodysplasia-Related Changes: Development, Challenges, and Treatment Advances

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