Medical Oncology

, Volume 29, Issue 4, pp 2348–2358

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

Authors

    • Division of Haematology, Department of Medicine, Karolinska Institutet Huddinge and Haematology Centre KarolinskaKarolinska University Hospital Huddinge
  • M. Remberger
    • Centre for Allogeneic Stem Cell Transplantation, Karolinska InstitutetKarolinska University Hospital Huddinge
  • M. Machaczka
    • Division of Haematology, Department of Medicine, Karolinska Institutet Huddinge and Haematology Centre KarolinskaKarolinska University Hospital Huddinge
  • J. Ungerstedt
    • Division of Haematology, Department of Medicine, Karolinska Institutet Huddinge and Haematology Centre KarolinskaKarolinska University Hospital Huddinge
  • J. Mattson
    • Centre for Allogeneic Stem Cell Transplantation, Karolinska InstitutetKarolinska University Hospital Huddinge
  • O. Ringden
    • Centre for Allogeneic Stem Cell Transplantation, Karolinska InstitutetKarolinska University Hospital Huddinge
  • Katarina Le-Blanc
    • Division of Haematology, Department of Medicine, Karolinska Institutet Huddinge and Haematology Centre KarolinskaKarolinska University Hospital Huddinge
  • P. Ljungman
    • Division of Haematology, Department of Medicine, Karolinska Institutet Huddinge and Haematology Centre KarolinskaKarolinska University Hospital Huddinge
  • H. Hägglund
    • Division of Haematology, Department of Medicine, Karolinska Institutet Huddinge and Haematology Centre KarolinskaKarolinska University Hospital Huddinge
Original Paper

DOI: 10.1007/s12032-011-0155-y

Cite this article as:
Nahi, H., Remberger, M., Machaczka, M. et al. Med Oncol (2012) 29: 2348. doi:10.1007/s12032-011-0155-y

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 leukaemiaAllogeneic transplantationCytogeneticsIntermediateUnfavourableChromosomal aberrations

Copyright information

© Springer Science+Business Media, LLC 2012