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Allogeneic HSCT and AML: Prognostic Impact of Unsuccessful Cytogenetic Analysis at Baseline

By: Joshua D. Madera, MS
Posted: Tuesday, January 12, 2021

For patients with acute myeloid leukemia, outcomes after transplantation of allogeneic hematopoietic stem cells (allo-HSCT) are comparable in those with unsuccessful cytogenetic analysis and in those with normal cytogenetics, according to a study published in Hematology/Oncology and Stem Cell Therapy. In addition, allo-HSCT “may mitigate the poor prognostic of unsuccessful analysis” in this patient population, explained Arjun Datt Law, MBBS, MD, DM, of the Princess Margaret Cancer Centre at the University of Toronto, and colleagues.

From 2011 to 2019, a total of 243 patients with AML were recruited for the study. Patients were stratified based on cytogenetic status: those with an unsuccessful cytogenetic analysis (n = 79) and those with a normal karyotype (n = 164). All patients underwent allo-HSCT.

The authors did not report any significant differences in relapse-free survival (66 months vs. 42 months, respectively) or overall survival (77 months vs. 76 months, respectively) between patients with unsuccessful and normal cytogenetic status. These findings also remained consistent when patients were stratified based on NPM1 and FLT3 gene mutation status.

Furthermore, the authors identified significant predictors of overall survival in patients with unsuccessful cytogenetic status following allo-HSCT. They included increased age (hazard ratio = 1.049), favorable mutation profile (hazard ratio = 0.11), neutrophil engraftment less than 17 days (hazard ratio = 4.17), and absence of chronic graft-versus-host-disease (hazard ratio = 3.27).

“Incorporating next-generation sequencing is likely to help further stratify patients where conventional karyotyping and molecular analysis do not provide sufficient prognostic information,” reported Dr. Law.

Disclosure: For full disclosures of the study authors, visit sciencedirect.com.


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