Allogeneic stem cell transplantation for AML patients with RUNX1 mutation in first complete remission: a study on behalf of the acute leukemia working party of the EBMT

J. Waidhauser, M. Labopin, J. Esteve, N. Kroger, J. Cornelissen, T. Gedde-Dahl, G. Van Gorkom, J. Finke, M. Rovira, N. Schaap, E. Petersen, D. Beelen, D. Bunjes, B. Savani, C. Schmid*, A. Nagler, M. Mohty, Acute Leukemia Working Party of EBMT

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Web of Science)

Abstract

Acute myeloid leukemia with runt-related transcription factor 1 gene mutation (RUNX1+ AML) is associated with inferior response rates and outcome after conventional chemotherapy. We performed a retrospective, registry-based analysis to elucidate the prognostic value of RUNX1 mutation after allogeneic stem cell transplantation (alloSCT). All consecutive adults undergoing alloSCT for AML in first complete remission (CR1) between 2013 and 2019 with complete information on conventional cytogenetics and RUNX1 mutational status were included. Endpoints of interest were cumulative relapse incidence, non-relapse mortality, overall and leukemia-free survival (OS/LFS), and GvHD-free/relapse-free survival. A total of 674 patients (183 RUNX1+, 491 RUNX1-) were identified, with >85% presenting as de novo AML. Median follow-up was 16.4 (RUNX1+) and 21.9 (RUNX1-) months. Survival rates showed no difference between RUNX1+ and RUNX1- patients either in univariate or multivariate analysis (2-year OS: 67.7 vs. 66.1%, p = 0.7; 2-year LFS: 61.1 vs. 60.8%, p = 0.62). Multivariate analysis identified age, donor type and poor cytogenetics as risk factors for inferior outcome. Among patients with RUNX+ AML, older age, reduced intensity conditioning and minimal residual disease at alloSCT predicted inferior outcome. Our data provide evidence that the negative influence of RUNX1 mutations in patients with AML can be overcome by transplantation in CR1.
Original languageEnglish
Pages (from-to)2445-2453
Number of pages9
JournalBone Marrow Transplantation
Volume56
Issue number10
Early online date31 May 2021
DOIs
Publication statusPublished - Oct 2021

Keywords

  • ACUTE MYELOID-LEUKEMIA
  • ADULT PATIENTS
  • YOUNGER
  • PROGNOSIS
  • DIAGNOSIS
  • DISEASE
  • IMPACT
  • GENE

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