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Can Early Cytogenetic Testing Improve Outcomes With HCT in AML?

By: Dana A. Elya, MS, RD, CDN
Posted: Wednesday, March 11, 2020

For patients with acute myeloid leukemia (AML) who have high-risk cytogenetics, undergoing early cytogenetic testing with an organized effort to identify a suitable donor for allogeneic hematopoietic cell transplantation (HCT) may improve both transplantation rates and survival outcomes. These findings from the SWOG-led intergroup study S1203 were published in JCO Oncology Practice by John M. Pagel, MD, PhD, of the Swedish Cancer Institute, Seattle, and colleagues.

“The study results suggest that better outcomes among these poor prognostic patients can be achieved by a simple approach of early HLA typing, donor identification, and expedited referral for hematopoietic call transplantation,” shared the researchers.

A total of 738 patients took part in the study; 159 (22%) had high-risk cytogenetics, and of those patients, 107 (67%) achieved first complete remission. A total of 70 of the high-risk patients (65%) underwent transplantation in first complete remission.

The median time from HCT to first complete remission was 77 days. Overall survival at 2 years was 48% for those patients who underwent transplantation compared with 35% for patients who did not undergo transplantation (P = .031). Relapse-free survival after transplantation in the high-risk patients who underwent transplantation in first complete remission was on average 11.5 months, and the median overall survival after transplantation was 14 months.

Although the study findings center on the impact of early HLA typing and transplantation consultation, the study authors emphasized a remaining gap between comprehensive cancer centers and community centers. “As such, HCT centers will be encouraged to increase their outreach to community cancer groups that refer patients for transplantation and educate them on the importance of early HLA typing and transplantation consultation,” the researchers concluded.

Disclosure: The authors’ disclosure information can be found at ascopubs.org.



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