Impact of depth of clinical response on outcomes of acute myeloid leukemia patients in first complete remission who undergo allogeneic hematopoietic cell transplantation

M.E. Percival*, H.L. Wang, M.J. Zhang, W. Saber, M. de Lima, M. Litzow, P. Kebriaei, H. Abdel-Azim, K. Adekola, M. Aljurf, U. Bacher, S.M. Badawy, A. Beitinjaneh, N. Bejanyan, V. Bhatt, M. Byrne, J.Y. Cahn, P. Castillo, N. Chao, S. ChhabraE. Copelan, C. Cutler, Z. DeFilipp, A. Dias, M.A. Diaz, E. Estey, N. Farhadfar, H.A. Frangoul, C.O. Freytes, R.P. Gale, S. Ganguly, L. Gowda, M. Grunwald, N. Hossain, R.T. Kamble, C.G. Kanakry, A. Kansagra, M.A. Kharfan-Dabaja, M. Krem, H.M. Lazarus, J.W. Lee, J.L. Liesveld, R.C. Lin, H.T. Liu, J. McGuirk, R. Munker, H.S. Murthy, S. Nathan, T. Nishihori, R.F. Olsson, M. van der Poel

*Corresponding author for this work

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Acute myeloid leukemia (AML) patients often undergo allogeneic hematopoietic cell transplantation (alloHCT) in first complete remission (CR). We examined the effect of depth of clinical response, including incomplete count recovery (CRi) and/or measurable residual disease (MRD), in patients from the Center for International Blood and Marrow Transplantation Research (CIBMTR) registry. We identified 2492 adult patients (1799 CR and 693 CRi) who underwent alloHCT between January 1, 2007 and December 31, 2015. The primary outcome was overall survival (OS). Multivariable analysis was performed to adjust for patient-, disease-, and transplant-related factors. Baseline characteristics were similar. Patients in CRi compared to those in CR had an increased likelihood of death (HR: 1.27; 95% confidence interval: 1.13-1.43). Compared to CR, CRi was significantly associated with increased non-relapse mortality (NRM), shorter disease-free survival (DFS), and a trend toward increased relapse. Detectable MRD was associated with shorter OS, shorter DFS, higher NRM, and increased relapse compared to absence of MRD. The deleterious effects of CRi and MRD were independent. In this large CIBMTR cohort, survival outcomes differ among AML patients based on depth of CR and presence of MRD at the time of alloHCT. Further studies should focus on optimizing post-alloHCT outcomes for patients with responses less than CR.
Original languageEnglish
Pages (from-to)2108-2117
Number of pages10
JournalBone Marrow Transplantation
Issue number9
Publication statusPublished - 1 Sept 2021
  • Correction to: Impact of depth of clinical response on outcomes of acute myeloid leukemia patients in first complete remission who undergo allogeneic hematopoietic cell transplantation

    Percival, M-E., Wang, H-L., Zhang, M-J., Saber, W., de Lima, M., Litzow, M., Kebriaei, P., Abdel-Azim, H., Adekola, K., Aljurf, M., Bacher, U., Badawy, S. M., Beitinjaneh, A., Bejanyan, N., Bhatt, V., Byrne, M., Cahn, J-Y., Castillo, P., Chao, N., Chhabra, S., & 47 othersCopelan, E., Cutler, C., DeFilipp, Z., Dias, A., Diaz, M. A., Estey, E., Farhadfar, N., Frangoul, H. A., Freytes, C. O., Gale, R. P., Ganguly, S., Gowda, L., Grunwald, M., Hossain, N., Kamble, R. T., Kanakry, C. G., Kansagra, A., Kharfan-Dabaja, M. A., Krem, M., Lazarus, H. M., Lee, J. W., Liesveld, J. L., Lin, R., Liu, H., McGuirk, J., Munker, R., Murthy, H. S., Nathan, S., Nishihori, T., Olsson, R. F., Palmisiano, N., Passweg, J. R., Prestidge, T., Ringdén, O., Rizzieri, D. A., Rybka, W. B., Savoie, M. L., Schultz, K. R., Seo, S., Sharma, A., Solh, M., Strair, R., van der Poel, M., Verdonck, L. F., Yared, J. A., Weisdorf, D. & Sandmaier, B. M., Sept 2021, In: Bone Marrow Transplantation. 56, 9, p. 2319-2319 1 p., 2319.

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