Page 265 - Haematologica - Vol. 105 n. 6 - June 2020

Stem Cell Transplantation
Allogeneic stem cell transplantation in second complete remission for core binding factor acute myeloid leukemia: a study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation
Kazimierz Halaburda,1* Myriam Labopin,2,3* Audrey Mailhol,2 Gerard Socié,4 Charles Craddock,5 Mahmoud Aljurf,6 Dietrich Beelen,7 Jan J. Cornelissen,8 Jean-Henri Bourhis,9 Hélène Labussière-Wallet,10 Didier Blaise,11 Tobias Gedde- Dahl,12 Maria Gilleece,13 Ibrahim Yakoub-Agha,14 Ghulam Mufti,15 Jordi Esteve,16 Mohamad Mohty2,3 and Arnon Nagler2,17*
1Institute of Haematology and Transfusion Medicine, Warsaw, Poland; 2EBMT Paris Study Office, Paris, France; 3Saint Antoine Hospital, Paris, France; 4St. Louis Hospital, Paris, France; 5Queen Elizabeth Hospital, Birmingham, UK; 6King Faisal Hospital, Riyadh, Saudi Arabia; 7University Hospital, Essen, Germany; 8Erasmus MC Cancer Institute, Rotterdam, the Netherlands; 9Gustave Roussy Institut de Cancérologie, Villejuif, France; 10Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Lyon, France; 11Institut Paoli Calmettes, Marseille, France; 12Oslo University Hospital, Oslo, Norway; 13St James’s Institute of Oncology, Leeds, UK; 14CHU de Lille, LIRIC, INSERM U995, Université de Lille, 59000 Lille, France; 15GKT School of Medicine, London, UK; 16Hospital Clinic, Barcelona, Spain and 17Chaim Sheba Medical Center, Tel Hashomer, Israel
*KH, ML and AN contributed equally as co-first authors.
ABSTRACT
Core binding factor acute myeloid leukemia (AML) comprises two subtypes with distinct cytogenetic abnormalities of either t(8;21)(q22;q22) or inv(16)(p13q22)/t(16;16)(p13;q22). Since long- term response to chemotherapy in these leukemias is relatively good, allogeneic hematopoietic stem cell transplantation is considered in patients who relapse and achieve second complete remission. To evalu- ate the outcomes of allogeneic transplantation in this indication, we studied 631 patients reported to the European Society for Blood and Marrow Transplantation Registry between the years 2000 and 2014. Leukemia-free survival probabilities at two and five years were 59.1% and 54.1%, while overall survival probabilities were 65% and 58.2%, respectively. The incidence of relapse and risk of non-relapse mortality at the same time points were 19.8% and 22.5% for relapse and 20.9% and 23.3% for non-relapse mortality, respectively. The most important adverse factors influencing leukemia-free and overall survival were: leukemia with t(8;21), presence of three or more additional chromosomal abnormalities, and Karnofsky performance score <80. Relapse risk was increased in t(8;21) leukemia and associated with additional cytogenetic abnormalities as well as reduced intensity conditioning. Measurable residual disease in molecular evaluation before transplantation was asso- ciated with increased risk of relapse and inferior leukemia-free survival.
Introduction
Core binding factor (CBF) leukemia represents up to 12% of all newly diagnosed adult acute myeloid leukemia (AML).1 Chromosomal markers of CBF AML include t(8;21)(q22;q22) and inv(16)(p13q22) or less frequently t(16;16)(p13;q22), further described jointly as inv(16). As a result of chromosomal abnormalities, fusion tran- scripts RUNX1-RUNX1T1 in t(8; 21) and CBFB-MYH11 in inv(16) emerge. The tran-
Ferrata Storti Foundation
Haematologica 2020 Volume 105(6):1723-1730
Correspondence:
KAZIMIERZ HALABURDA
khalab30@wp.pl
Received: March 22, 2019. Accepted: August 14, 2019. Pre-published: August 22, 2019.
doi:10.3324/haematol.2019.222810
Check the online version for the most updated information on this article, online supplements, and information on authorship & disclosures: www.haematologica.org/content/105/6/1723
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