Classifying cytogenetics in patients with acute myelogenous leukemia in complete remission undergoing allogeneic transplantation: a Center for International Blood and Marrow Transplant Research study Journal Article

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Authors: Armand, P.; Kim, H. T.; Zhang, M. J.; Perez, W. S.; Dal Cin, P. S.; Klumpp, T. R.; Waller, E. K.; Litzow, M. R.; Liesveld, J. L.; Lazarus, H. M.; Artz, A. S.; Gupta, V; Savani, B. N.; McCarthy, P. L.; Cahn, J. Y.; Schouten, H. C.; Finke, J.; Ball, E. D.; Aljurf, M. D.; Cutler, C. S.; Rowe, J. M.; Antin, J. H.; Isola, L. M.; Di Bartolomeo, P.; Camitta, B. M.; Miller, A. M.; Cairo, M. S.; Stockerl-Goldstein, K; Sierra, J.; Savoie, M. L.; Halter, J.; Stiff, P. J.; Nabhan, C.; Jakubowski, A. A.; Bunjes, D. W.; Petersdorf, E. W.; Devine, S. M.; Maziarz, R. T.; Bornhauser, M.; Lewis, V. A.; Marks, D. I.; Bredeson, C. N.; Soiffer, R. J.; Weisdorf, D. J.
Article Title: Classifying cytogenetics in patients with acute myelogenous leukemia in complete remission undergoing allogeneic transplantation: a Center for International Blood and Marrow Transplant Research study
Abstract: Cytogenetics play a major role in determining the prognosis of patients with acute myelogenous leukemia (AML). However, existing cytogenetics classifications were developed in chemotherapy-treated patients and might not be optimal for patients undergoing allogeneic hematopoietic cell transplantation (HCT). We studied 821 adult patients reported to the Center for International Blood and Marrow Transplant Research (CIBMTR) who underwent HCT for AML in first or second complete remission between 1999 and 2004. We compared the ability of the 6 existing classifications to stratify patients by overall survival. We then defined a new scheme specifically applicable to patients undergoing HCT using this patient cohort. Under this scheme, inv(16) is favorable, a complex karyotype (4 or more abnormalities) is adverse, and all other classified abnormalities are intermediate in predicting survival after HCT (5-year overall survival, 64%, 18%, and 50%, respectively; P = .0001). This scheme stratifies patients into 3 groups with similar nonrelapse mortality, but significantly different incidences of relapse, overall and leukemia-free survival. It applies to patients regardless of disease status (first or second complete remission), donor type (matched related or unrelated), or conditioning intensity (myeloablative or reduced intensity). This transplantation-specific classification could be adopted for prognostication purposes and to stratify patients with AML and karyotypic abnormalities entering HCT clinical trials.
Journal Title: Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
Volume: 18
Issue: 2
ISSN: 1523-6536; 1083-8791
Publisher: Elsevier Inc  
Journal Place: United States
Date Published: 2012
Start Page: 280
End Page: 288
Language: eng
DOI/URL:

10.1016/j.bbmt.2011.07.024

10.1016/j.bbmt.2011.07.024
Notes: LR: 20130628; CI: Copyright (c) 2012; GR: 5U01HL069294/HL/NHLBI NIH HHS/United States; GR: P01HL 070149/HL/NHLBI NIH HHS/United States; GR: U19 AI 29530/AI/NIAID NIH HHS/United States; GR: U19 AI029530/AI/NIAID NIH HHS/United States; GR: U19 AI029530-17/AI/NIAID NIH HHS/United States; GR: U24 CA076518-12/CA/NCI NIH HHS/United States; GR: U24-CA76518/CA/NCI NIH HHS/United States; JID: 9600628; CIN: Biol Blood Marrow Transplant. 2012 Feb;18(2):160-1. PMID: 22155503; NIHMS316575; OID: NLM: NIHMS316575; OID: NLM: PMC3224672; 2011/05/26 [received]; 2011/07/27 [accepted]; 2011/07/31 [aheadofprint]; ppublish