Original Paper

Medical Oncology

, Volume 29, Issue 4, pp 2348-2358

First online:

Different impact of intermediate and unfavourable cytogenetics at the time of diagnosis on outcome of de novo AML after allo-SCT: a long-term retrospective analysis from a single institution

  • H. NahiAffiliated withDivision of Haematology, Department of Medicine, Karolinska Institutet Huddinge and Haematology Centre Karolinska, Karolinska University Hospital Huddinge Email author 
  • , M. RembergerAffiliated withCentre for Allogeneic Stem Cell Transplantation, Karolinska Institutet, Karolinska University Hospital Huddinge
  • , M. MachaczkaAffiliated withDivision of Haematology, Department of Medicine, Karolinska Institutet Huddinge and Haematology Centre Karolinska, Karolinska University Hospital Huddinge
  • , J. UngerstedtAffiliated withDivision of Haematology, Department of Medicine, Karolinska Institutet Huddinge and Haematology Centre Karolinska, Karolinska University Hospital Huddinge
  • , J. MattsonAffiliated withCentre for Allogeneic Stem Cell Transplantation, Karolinska Institutet, Karolinska University Hospital Huddinge
  • , O. RingdenAffiliated withCentre for Allogeneic Stem Cell Transplantation, Karolinska Institutet, Karolinska University Hospital Huddinge
  • , Katarina Le-BlancAffiliated withDivision of Haematology, Department of Medicine, Karolinska Institutet Huddinge and Haematology Centre Karolinska, Karolinska University Hospital Huddinge
  • , P. LjungmanAffiliated withDivision of Haematology, Department of Medicine, Karolinska Institutet Huddinge and Haematology Centre Karolinska, Karolinska University Hospital Huddinge
  • , H. HägglundAffiliated withDivision of Haematology, Department of Medicine, Karolinska Institutet Huddinge and Haematology Centre Karolinska, Karolinska University Hospital Huddinge

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Abstract

Karyotype of myeloblasts at the time of AML diagnosis has been shown to be prognostic significant for pre-remission outcome and outcome after allo-SCT, but the latter requires further studies. We conducted a retrospective analysis of the impact of intermediate and unfavourable cytogenetics at the time of primary diagnosis on outcome after allo-SCT in de novo AML. The study included 169 patients who underwent allo-SCT at Karolinska University Hospital between 1980 and 2010. Intermediate and unfavourable cytogenetics were found in 129 (76%) and 40 patients (24%), respectively. Myeloablative and reduced-intensity conditioning were given to 120 (71%) and 49 (29%) patients, respectively. Allo-SCT was performed in CR1 in 122 patients (72%). TRM was 16% in both cytogenetics groups. Relapse occurred in 29% patients with intermediate and in 45% patients with unfavourable cytogenetics (P = 0.01). The probabilities of 5-year OS for patients with intermediate and unfavourable cytogenetics were 60 and 43%, respectively (P = 0.02). Multivariate analysis revealed intermediate cytogenetics, chronic GVHD, and recipient CMV-negative serostatus as variables associated with favourable OS. Our study showed that outcome after allo-SCT in de novo AML differs depending on cytogenetic risk-group; however its position in post-remission therapy of eligible AML patients is not threatened.

Keywords

Acute myeloid leukaemia Allogeneic transplantation Cytogenetics Intermediate Unfavourable Chromosomal aberrations