Cytogenetic risk determines outcomes after allogeneic transplantation in older patients with acute myeloid leukemia in their second complete remission: A Center for International Blood and Marrow Transplant Research cohort analysis

for the Acute Leukemia Working Committee of the Center for International Blood and Marrow Transplant Research, aresearch collaboration between the National Marrow Donor Program/Be the Match Registry and theMedicalCollegeofWisconsin

doi:10.1002/cncr.30567

Cytogenetic risk determines outcomes after allogeneic transplantation in older patients with acute myeloid leukemia in their second complete remission: A Center for International Blood and Marrow Transplant Research cohort analysis

for the Acute Leukemia Working Committee of the Center for International Blood and Marrow Transplant Research, aresearch collaboration between the National Marrow Donor Program/Be the Match Registry and theMedicalCollegeofWisconsin

Medicine, Hematology Oncology Division

Research output: Contribution to journal › Article › peer-review

11 Scopus citations

Abstract

BACKGROUND: Allogeneic hematopoietic cell transplantation (HCT) offers curative potential to a number of older patients with acute myeloid leukemia (AML) in their first complete remission. However, there are limited data in the literature concerning post-HCT outcomes for older patients in their second complete remission (CR2). METHODS: The purpose of the current study was to retrospectively investigate within the Center for International Blood and Marrow Transplant Research database parameters influencing posttransplant outcomes for patients 60 years of age or older undergoing HCT for AML in CR2. RESULTS: In total, 196 patients from 78 centers were identified; the median age was 64 years (range, 60-78 years). Seventy-one percent had a Karnofsky performance status ≥ 90 at the time of HCT. Reduced-intensity conditioning regimens were used in 159 patients (81%). A univariate analysis demonstrated a 3-year overall survival (OS) rate of 42% (95% confidence interval [CI], 35%-49%), a leukemia-free survival rate of 37% (95% CI, 30%-44%), a cumulative incidence of nonrelapse mortality of 25% (95% CI, 19%-32%), and a cumulative incidence of relapse (CIR) of 38% (95% CI, 31%-45%). A multivariate analysis demonstrated that cytogenetic risk was the only independent risk factor for OS (P =.023) with a hazard ratio (HR) of 1.14 (95% CI, 0.59-2.19) for intermediate-risk cytogenetics and an HR of 2.32 (95% CI, 1.05-5.14) for unfavorable-risk cytogenetics. For CIR, cytogenetic risk was also the only independent prognostic factor (P =.01) with an HR of 1.10 (95% CI, 0.47-2.56) for intermediate-risk cytogenetics and an HR of 2.98 (95% CI, 1.11-8.00) for unfavorable-risk cytogenetics. CONCLUSIONS: Allogeneic HCT is a curative treatment option for older patients with AML in CR2, particularly for those with favorable or intermediate cytogenetic risk. Cancer 2017;123:2035–2042.

Original language	English (US)
Pages (from-to)	2035-2042
Number of pages	8
Journal	cancer
Volume	123
Issue number	11
DOIs	https://doi.org/10.1002/cncr.30567
State	Published - Jun 1 2017

Funding

The Center for International Blood and Marrow Transplant Research is supported by the following: a Public Health Service grant/cooperative agreement (5U24-CA076518) from the National Cancer Institute, the National Heart, Lung, and Blood Institute, and the National Institute of Allergy and Infectious Diseases; a grant/cooperative agreement (5U10HL069294) from the National Heart, Lung, and Blood Institute and the National Cancer Institute; a contract (HHSH250201200016C) from the Health Resources and Services Administration/Department of Health and Human Services; grants (N00014-15-1-0848 and N00014-16-1-2020) from the Office of Naval Research; grants from Alexion; Amgen, Inc (corporate member); an anonymous donation to the Medical College of Wisconsin; Astellas Pharma US; AstraZeneca; the Be the Match Foundation; Bluebird Bio, Inc (corporate member); Bristol-Myers Squibb Oncology (corporate member); Celgene Corporation (corporate member); Cellular Dynamics International, Inc; Chimerix, Inc (corporate member); the Fred Hutchinson Cancer Research Center; Gamida Cell, Ltd; Genentech, Inc; Genzyme Corporation; Gilead Sciences, Inc (corporate member); Health Research, Inc; the Roswell Park Cancer Institute; HistoGenetics, Inc; Incyte Corporation; Janssen Scientific Affairs, LLC; Jazz Pharmaceuticals, Inc (corporate member); the Jeff Gordon Children's Foundation; the Leukemia & Lymphoma Society; Medac, GmbH; MedImmune; the Medical College of Wisconsin; Merck & Co, Inc (corporate member); Mesoblast; MesoScale Diagnostics, Inc; Miltenyi Biotec, Inc (corporate member); the National Marrow Donor Program; Neovii Biotech NA, Inc; Novartis Pharmaceuticals Corporation; Onyx Pharmaceuticals; Optum Healthcare Solutions, Inc; Otsuka America Pharmaceutical, Inc; Otsuka Pharmaceutical Co, Ltd (Japan); the Patient-Centered Outcomes Research Institute; PerkinElmer, Inc; Pfizer, Inc; Sanofi US (corporate member); Seattle Genetics (corporate member); Spectrum Pharmaceuticals, Inc (corporate member); the St. Baldrick's Foundation; Sunesis Pharmaceuticals, Inc (corporate member); Swedish Orphan Biovitrum, Inc; Takeda Oncology; Telomere Diagnostics, Inc; the University of Minnesota; and WellPoint, Inc (corporate member). The views expressed in this article do not reflect the official policy or position of the National Institutes of Health, the Department of the Navy, the Department of Defense, the Health Resources and Services Administration, or any other agency of the US Government.

Keywords

Center for International Blood and Marrow Transplant Research (CIBMTR)
acute myeloid leukemia (AML)
allogeneic transplant
elderly
second complete remission

ASJC Scopus subject areas

Oncology
Cancer Research

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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for the Acute Leukemia Working Committee of the Center for International Blood and Marrow Transplant Research, aresearch collaboration between the National Marrow Donor Program/Be the Match Registry and theMedicalCollegeofWisconsin (2017). Cytogenetic risk determines outcomes after allogeneic transplantation in older patients with acute myeloid leukemia in their second complete remission: A Center for International Blood and Marrow Transplant Research cohort analysis. cancer, 123(11), 2035-2042. https://doi.org/10.1002/cncr.30567

for the Acute Leukemia Working Committee of the Center for International Blood and Marrow Transplant Research, aresearch collaboration between the National Marrow Donor Program/Be the Match Registry and theMedicalCollegeofWisconsin. / Cytogenetic risk determines outcomes after allogeneic transplantation in older patients with acute myeloid leukemia in their second complete remission : A Center for International Blood and Marrow Transplant Research cohort analysis. In: cancer. 2017 ; Vol. 123, No. 11. pp. 2035-2042.

@article{0ec34c99dfd449b89e431dc872ea2ac9,

title = "Cytogenetic risk determines outcomes after allogeneic transplantation in older patients with acute myeloid leukemia in their second complete remission: A Center for International Blood and Marrow Transplant Research cohort analysis",

abstract = "BACKGROUND: Allogeneic hematopoietic cell transplantation (HCT) offers curative potential to a number of older patients with acute myeloid leukemia (AML) in their first complete remission. However, there are limited data in the literature concerning post-HCT outcomes for older patients in their second complete remission (CR2). METHODS: The purpose of the current study was to retrospectively investigate within the Center for International Blood and Marrow Transplant Research database parameters influencing posttransplant outcomes for patients 60 years of age or older undergoing HCT for AML in CR2. RESULTS: In total, 196 patients from 78 centers were identified; the median age was 64 years (range, 60-78 years). Seventy-one percent had a Karnofsky performance status ≥ 90 at the time of HCT. Reduced-intensity conditioning regimens were used in 159 patients (81%). A univariate analysis demonstrated a 3-year overall survival (OS) rate of 42% (95% confidence interval [CI], 35%-49%), a leukemia-free survival rate of 37% (95% CI, 30%-44%), a cumulative incidence of nonrelapse mortality of 25% (95% CI, 19%-32%), and a cumulative incidence of relapse (CIR) of 38% (95% CI, 31%-45%). A multivariate analysis demonstrated that cytogenetic risk was the only independent risk factor for OS (P =.023) with a hazard ratio (HR) of 1.14 (95% CI, 0.59-2.19) for intermediate-risk cytogenetics and an HR of 2.32 (95% CI, 1.05-5.14) for unfavorable-risk cytogenetics. For CIR, cytogenetic risk was also the only independent prognostic factor (P =.01) with an HR of 1.10 (95% CI, 0.47-2.56) for intermediate-risk cytogenetics and an HR of 2.98 (95% CI, 1.11-8.00) for unfavorable-risk cytogenetics. CONCLUSIONS: Allogeneic HCT is a curative treatment option for older patients with AML in CR2, particularly for those with favorable or intermediate cytogenetic risk. Cancer 2017;123:2035–2042.",

keywords = "Center for International Blood and Marrow Transplant Research (CIBMTR), acute myeloid leukemia (AML), allogeneic transplant, elderly, second complete remission",

author = "{for the Acute Leukemia Working Committee of the Center for International Blood and Marrow Transplant Research, aresearch collaboration between the National Marrow Donor Program/Be the Match Registry and theMedicalCollegeofWisconsin} and Michelis, {Fotios V.} and Vikas Gupta and Zhang, {Mei Jie} and Wang, {Hai Lin} and Mahmoud Aljurf and Ulrike Bacher and Amer Beitinjaneh and Chen, {Yi Bin} and Zachariah DeFilipp and Gale, {Robert Peter} and Partow Kebriaei and Mohamed Kharfan-Dabaja and Lazarus, {Hillard M.} and Taiga Nishihori and Olsson, {Richard F.} and Betul Oran and Armin Rashidi and Rizzieri, {David A.} and Tallman, {Martin S.} and {de Lima}, Marcos and Khoury, {H. Jean} and Sandmaier, {Brenda M.} and Daniel Weisdorf and Wael Saber",

note = "Publisher Copyright: {\textcopyright} 2017 American Cancer Society",

year = "2017",

month = jun,

day = "1",

doi = "10.1002/cncr.30567",

language = "English (US)",

volume = "123",

pages = "2035--2042",

journal = "cancer",

issn = "0008-543X",

publisher = "John Wiley and Sons Inc.",

number = "11",

}

for the Acute Leukemia Working Committee of the Center for International Blood and Marrow Transplant Research, aresearch collaboration between the National Marrow Donor Program/Be the Match Registry and theMedicalCollegeofWisconsin 2017, 'Cytogenetic risk determines outcomes after allogeneic transplantation in older patients with acute myeloid leukemia in their second complete remission: A Center for International Blood and Marrow Transplant Research cohort analysis', cancer, vol. 123, no. 11, pp. 2035-2042. https://doi.org/10.1002/cncr.30567

Cytogenetic risk determines outcomes after allogeneic transplantation in older patients with acute myeloid leukemia in their second complete remission: A Center for International Blood and Marrow Transplant Research cohort analysis. / for the Acute Leukemia Working Committee of the Center for International Blood and Marrow Transplant Research, aresearch collaboration between the National Marrow Donor Program/Be the Match Registry and theMedicalCollegeofWisconsin.
In: cancer, Vol. 123, No. 11, 01.06.2017, p. 2035-2042.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Cytogenetic risk determines outcomes after allogeneic transplantation in older patients with acute myeloid leukemia in their second complete remission

T2 - A Center for International Blood and Marrow Transplant Research cohort analysis

AU - for the Acute Leukemia Working Committee of the Center for International Blood and Marrow Transplant Research, aresearch collaboration between the National Marrow Donor Program/Be the Match Registry and theMedicalCollegeofWisconsin

AU - Michelis, Fotios V.

AU - Gupta, Vikas

AU - Zhang, Mei Jie

AU - Wang, Hai Lin

AU - Aljurf, Mahmoud

AU - Bacher, Ulrike

AU - Beitinjaneh, Amer

AU - Chen, Yi Bin

AU - DeFilipp, Zachariah

AU - Gale, Robert Peter

AU - Kebriaei, Partow

AU - Kharfan-Dabaja, Mohamed

AU - Lazarus, Hillard M.

AU - Nishihori, Taiga

AU - Olsson, Richard F.

AU - Oran, Betul

AU - Rashidi, Armin

AU - Rizzieri, David A.

AU - Tallman, Martin S.

AU - de Lima, Marcos

AU - Khoury, H. Jean

AU - Sandmaier, Brenda M.

AU - Weisdorf, Daniel

AU - Saber, Wael

PY - 2017/6/1

Y1 - 2017/6/1

N2 - BACKGROUND: Allogeneic hematopoietic cell transplantation (HCT) offers curative potential to a number of older patients with acute myeloid leukemia (AML) in their first complete remission. However, there are limited data in the literature concerning post-HCT outcomes for older patients in their second complete remission (CR2). METHODS: The purpose of the current study was to retrospectively investigate within the Center for International Blood and Marrow Transplant Research database parameters influencing posttransplant outcomes for patients 60 years of age or older undergoing HCT for AML in CR2. RESULTS: In total, 196 patients from 78 centers were identified; the median age was 64 years (range, 60-78 years). Seventy-one percent had a Karnofsky performance status ≥ 90 at the time of HCT. Reduced-intensity conditioning regimens were used in 159 patients (81%). A univariate analysis demonstrated a 3-year overall survival (OS) rate of 42% (95% confidence interval [CI], 35%-49%), a leukemia-free survival rate of 37% (95% CI, 30%-44%), a cumulative incidence of nonrelapse mortality of 25% (95% CI, 19%-32%), and a cumulative incidence of relapse (CIR) of 38% (95% CI, 31%-45%). A multivariate analysis demonstrated that cytogenetic risk was the only independent risk factor for OS (P =.023) with a hazard ratio (HR) of 1.14 (95% CI, 0.59-2.19) for intermediate-risk cytogenetics and an HR of 2.32 (95% CI, 1.05-5.14) for unfavorable-risk cytogenetics. For CIR, cytogenetic risk was also the only independent prognostic factor (P =.01) with an HR of 1.10 (95% CI, 0.47-2.56) for intermediate-risk cytogenetics and an HR of 2.98 (95% CI, 1.11-8.00) for unfavorable-risk cytogenetics. CONCLUSIONS: Allogeneic HCT is a curative treatment option for older patients with AML in CR2, particularly for those with favorable or intermediate cytogenetic risk. Cancer 2017;123:2035–2042.

AB - BACKGROUND: Allogeneic hematopoietic cell transplantation (HCT) offers curative potential to a number of older patients with acute myeloid leukemia (AML) in their first complete remission. However, there are limited data in the literature concerning post-HCT outcomes for older patients in their second complete remission (CR2). METHODS: The purpose of the current study was to retrospectively investigate within the Center for International Blood and Marrow Transplant Research database parameters influencing posttransplant outcomes for patients 60 years of age or older undergoing HCT for AML in CR2. RESULTS: In total, 196 patients from 78 centers were identified; the median age was 64 years (range, 60-78 years). Seventy-one percent had a Karnofsky performance status ≥ 90 at the time of HCT. Reduced-intensity conditioning regimens were used in 159 patients (81%). A univariate analysis demonstrated a 3-year overall survival (OS) rate of 42% (95% confidence interval [CI], 35%-49%), a leukemia-free survival rate of 37% (95% CI, 30%-44%), a cumulative incidence of nonrelapse mortality of 25% (95% CI, 19%-32%), and a cumulative incidence of relapse (CIR) of 38% (95% CI, 31%-45%). A multivariate analysis demonstrated that cytogenetic risk was the only independent risk factor for OS (P =.023) with a hazard ratio (HR) of 1.14 (95% CI, 0.59-2.19) for intermediate-risk cytogenetics and an HR of 2.32 (95% CI, 1.05-5.14) for unfavorable-risk cytogenetics. For CIR, cytogenetic risk was also the only independent prognostic factor (P =.01) with an HR of 1.10 (95% CI, 0.47-2.56) for intermediate-risk cytogenetics and an HR of 2.98 (95% CI, 1.11-8.00) for unfavorable-risk cytogenetics. CONCLUSIONS: Allogeneic HCT is a curative treatment option for older patients with AML in CR2, particularly for those with favorable or intermediate cytogenetic risk. Cancer 2017;123:2035–2042.

KW - Center for International Blood and Marrow Transplant Research (CIBMTR)

KW - acute myeloid leukemia (AML)

KW - allogeneic transplant

KW - elderly

KW - second complete remission

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UR - http://www.scopus.com/inward/citedby.url?scp=85019946749&partnerID=8YFLogxK

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DO - 10.1002/cncr.30567

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AN - SCOPUS:85019946749

SN - 0008-543X

VL - 123

SP - 2035

EP - 2042

JO - cancer

JF - cancer

IS - 11

ER -

for the Acute Leukemia Working Committee of the Center for International Blood and Marrow Transplant Research, aresearch collaboration between the National Marrow Donor Program/Be the Match Registry and theMedicalCollegeofWisconsin. Cytogenetic risk determines outcomes after allogeneic transplantation in older patients with acute myeloid leukemia in their second complete remission: A Center for International Blood and Marrow Transplant Research cohort analysis. cancer. 2017 Jun 1;123(11):2035-2042. doi: 10.1002/cncr.30567

Cytogenetic risk determines outcomes after allogeneic transplantation in older patients with acute myeloid leukemia in their second complete remission: A Center for International Blood and Marrow Transplant Research cohort analysis

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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