Impact of pre-transplant induction and consolidation cycles on AML allogeneic transplant outcomes: a CIBMTR analysis in 3113 AML patients

Michael Boyiadzis, University of Pittsburgh, Pittsburgh, PA, USA.Follow
Mei-Jie Zhang, CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
Karen Chen, CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
Hisham Abdel-Azim, Loma Linda University School of Medicine, Cancer Center, Children Hospital and Medical Center, Loma Linda, CA, USA.
Muhammad Bilal Abid, Divisions of Hematology/Oncology & Infectious Diseases, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.Follow
Mahmoud Aljurf, Department of Oncology, King Faisal Specialist Hospital Center & Research, Riyadh, Saudi Arabia.
Ulrike Bacher, Department of Hematology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Talha Badar, Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL, USA.Follow
Sherif M. Badawy, Division of Hematology, Oncology and Stem Cell Transplantation, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.Follow
Minoo Battiwalla, Sarah Cannon Blood Cancer Network, Nashville, TN, USA.Follow
Nelli Bejanyan, Department of Blood & Marrow Transplant and Cellular Immunotherapy (BMT CI), Moffitt Cancer Center, Tampa, FL, USA.Follow
Vijaya Raj Bhatt, The Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, USA.
Valerie I. Brown, Division of Pediatric Oncology/Hematology, Department of Pediatrics, Penn State Hershey Children's Hospital and College of Medicine, Hershey, PA, USA.Follow
Paul Castillo, UF Health Shands Children's Hospital, Gainesville, FL, USA.
Jan Cerny, Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical Center, Worcester, MA, USA.
Edward A. Copelan, Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, NC, USA.
Charles Craddock, Queen Elizabeth Hospital, Birmingham, UK.
Bhagirathbhai Dholaria, Vanderbilt University Medical Center, Nashville, TN, USA.
Miguel Angel Perez, Department of Hematology/Oncology, Hospital Infantil Universitario Niño Jesus, Madrid, Spain.
Christen L. Ebens, Division of Blood and Marrow Transplant & Cellular Therapy, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA.
Robert Peter Gale, Haematology Centre, Department of Immunology and Inflammation, Imperial College London, London, UK.
Siddhartha Ganguly, Houston Methodist Hospital and Cancer Center, Houston, TX, USA.
Lohith Gowda, Yale Cancer Center and Yale School of Medicine, New Haven, CT, USA.
Michael R. Grunwald, Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, NC, USA.
Shahrukh Hashmi, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
Gerhard C. Hildebrandt, University of Missouri, Ellis Fischel Cancer Center, Columbia, MO, USA.Follow
Madiha Iqbal, Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL, USA.
Omer Jamy, University of Alabama at Birmingham, Birmingham, AL, USA.
Mohamed A. Kharfan-Dabaja, Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL, USA.
Nandita Khera, Department of Hematology/Oncology, Mayo Clinic, Phoenix, AZ, USA.
Hillard M. Lazarus, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA.
Richard Lin, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

Document Type

Article

Publication Title

Leukemia

Abstract

We investigated the impact of the number of induction/consolidation cycles on outcomes of 3113 adult AML patients who received allogeneic hematopoietic cell transplantation (allo-HCT) between 2008 and 2019. Patients received allo-HCT using myeloablative (MAC) or reduced-intensity (RIC) conditioning in first complete remission (CR) or with primary induction failure (PIF). Patients who received MAC allo-HCT in CR after 1 induction cycle had 1.3-fold better overall survival (OS) than 2 cycles to CR and 1.47-fold better than ≥3 cycles. OS after CR in 2 or ≥3 cycles was similar. Relapse risk was 1.65-fold greater in patients receiving ≥3 cycles to achieve CR. After RIC allo-HCT, the number of induction cycles to CR did not affect OS. Compared to CR in 1 cycle, relapse risk was 1.24-1.41-fold greater in patients receiving 2 or ≥3 cycles. For patients receiving only 1 cycle to CR, consolidation therapy prior to MAC allo-HCT was associated with improved OS vs. no consolidation therapy. Detectable MRD at the time of MAC allo-HCT did not impact outcomes while detectable MRD preceding RIC allo-HCT was associated with an increased risk of relapse. For allo-HCT in PIF, OS was significantly worse than allo-HCT in CR after 1-3 cycles.

First Page

1006

Last Page

1017

DOI

10.1038/s41375-022-01738-3

Publication Date

5-1-2023

Identifier

36310182 (pubmed); NIHMS1868391 (mid); PMC10148918 (pmc); 10.1038/s41375-022-01738-3 (doi); 10.1038/s41375-022-01738-3 (pii)

This document is currently not available here.

Share

COinS