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

Mary Elizabeth Percival*, Hai Lin Wang, Mei Jie Zhang, Wael Saber, Marcos de Lima, Mark Litzow, Partow Kebriaei, Hisham Abdel-Azim, Kehinde Adekola, Mahmoud Aljurf, Ulrike Bacher, Sherif M. Badawy, Amer Beitinjaneh, Nelli Bejanyan, Vijaya Bhatt, Michael Byrne, Jean Yves Cahn, Paul Castillo, Nelson Chao, Saurabh ChhabraEdward Copelan, Corey Cutler, Zachariah DeFilipp, Ajoy Dias, Miguel Angel Diaz, Elihu Estey, Nosha Farhadfar, Haydar A. Frangoul, César O. Freytes, Robert Peter Gale, Siddhartha Ganguly, Lohith Gowda, Michael Grunwald, Nasheed Hossain, Rammurti T. Kamble, Christopher G. Kanakry, Ankit Kansagra, Mohamed A. Kharfan-Dabaja, Maxwell Krem, Hillard M. Lazarus, Jong Wook Lee, Jane L. Liesveld, Richard Lin, Hongtao Liu, Joseph McGuirk, Reinhold Munker, Hemant S. Murthy, Sunita Nathan, Taiga Nishihori, Richard F. Olsson, Neil Palmisiano, Jakob R. Passweg, Tim Prestidge, Olov Ringdén, David A. Rizzieri, Witold B. Rybka, Mary Lynn Savoie, Kirk R. Schultz, Sachiko Seo, Akshay Sharma, Melhem Solh, Roger Strair, Marjolein van der Poel, Leo F. Verdonck, Jean A. Yared, Daniel Weisdorf, Brenda M. Sandmaier

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

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 (US)
Pages (from-to)2108-2117
Number of pages10
JournalBone Marrow Transplantation
Volume56
Issue number9
DOIs
StatePublished - Sep 2021

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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