Allogeneic stem cell transplantation in de novo core-binding factor acute myeloid leukemia in active disease: a study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation.
Sara Tarantino, Myriam Labopin, Robert Zeiser, Matthias Stelljes, Thomas Schroeder, Nicolaus Kröger, Wolfgang Bethge, Jakob Passweg, Martin Bornhäuser, Christoph Schmid, Johanna Tischer, Matthias Eder, Eolia Brissot, Jordi Esteve, Arnon Nagler, Mohamad Mohty, Fabio Ciceri
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引用次数: 0
Abstract
Core-binding factor acute myeloid leukemia (CBF-AML) generally has a favorable prognosis, with allogeneic hematopoietic stem cell transplantation (allo-SCT) recommended for relapsed/ refractory (R/R) cases achieving second complete remission (CR). However, clinical outcomes remain suboptimal for patients who relapse or fail to achieve CR following induction chemotherapy. Allo-SCT in non-CR is a potential strategy for such patients, though supporting evidence in CBF-AML is limited. To assess outcomes and prognostic factors of allo-SCT in R/R CBF-AML with active disease, we conducted a retrospective analysis of 610 patients with CBF-AML in non-CR undergoing allo-SCT from 2010 to 2021 across 174 centers within the European Society for Blood and Marrow Transplantation. Graft sources included matched sibling (MSD, n = 151), unrelated (UD, n = 368), and haploidentical donors (Haplo, n = 91). Among patients, 124 had inv(16), and 486 had t(8;21). Two-year overall survival (OS) and leukemia-free survival (LFS) were 53.6% and 42.7%, respectively. Haplo-SCT showed inferior OS compared to MSD (HR 1.79, p = 0.003) and UD (HR 1.64, p = 0.004) and reduced chronic graft-versus-host disease. Patients with t(8;21) exhibited higher relapse incidence (HR 2.04, p = 0.002) and poorer survival outcomes than those with inv(16). These findings confirm the therapeutic role of allo-SCT in R/R CBF-AML in non-CR, supporting its favorable risk profile.
核心结合因子急性髓系白血病（CBF-AML）通常具有良好的预后，异体造血干细胞移植（alloo - sct）被推荐用于复发/难治性（R/R）患者实现第二次完全缓解（CR）。然而，对于诱导化疗后复发或未能达到CR的患者，临床结果仍然不理想。尽管支持CBF-AML的证据有限，但非cr患者的同种异体细胞移植是一种潜在的策略。为了评估伴有活动性疾病的R/R型CBF-AML的同种异体sct治疗的结果和预后因素，我们对2010年至2021年欧洲血液和骨髓移植协会174个中心的610例非cr型CBF-AML患者进行了回顾性分析。移植物来源包括匹配的兄弟姐妹（MSD, n = 151）、非亲属（UD, n = 368）和单倍体相同的供体（Haplo, n = 91）。患者中有124例（16例）有v， 486例（8例；21例）有t。2年总生存率（OS）和无白血病生存率（LFS）分别为53.6%和42.7%。与MSD （HR 1.79, p = 0.003）和UD （HR 1.64, p = 0.004）相比，单倍sct的OS较低，慢性移植物抗宿主病减少。与inv患者相比，t（8;21）患者的复发率更高（HR 2.04, p = 0.002），生存结果更差（16）。这些发现证实了同种异体sct在非cr的R/R CBF-AML中的治疗作用，支持其有利的风险特征。
期刊介绍：
Bone Marrow Transplantation publishes high quality, peer reviewed original research that addresses all aspects of basic biology and clinical use of haemopoietic stem cell transplantation.
The broad scope of the journal thus encompasses topics such as stem cell biology, e.g., kinetics and cytokine control, transplantation immunology e.g., HLA and matching techniques, translational research, and clinical results of specific transplant protocols. Bone Marrow Transplantation publishes 24 issues a year.
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