Prognostic index for patients with relapsed or refractory acute myeloid leukemia who underwent hematopoietic cell transplantation: a KSGCT multicenter analysis.

Abstract

A multicenter retrospective study was performed to explore a prognostic scoring index in order to identify a population who are least likely to benefit from allogeneic hematopoietic cell transplantation (HCT) in patients with relapsed or refractory acute myeloid leukemia (AML). The cohort included 519 patients with AML, who received HCT between 2005 and 2015 at a status of relapse or primary induction failure. Multivariate analysis demonstrated five independent predictors for OS, including C-reactive protein ≥ 1 mg/dL, peripheral blood blast fraction ≥ 20%, poor-risk karyotype, performance status ≥ 2, and bone marrow unrelated donor as a stem cell source. A prognostic scoring index was explored based on these predictors, and successfully separated the cohort into four groups. At 2 years, OS was 47%, 24%, 8%, and 0% for Good (Score 0, 1: n = 118), Intermediate-1 (Score 2: n = 75), Intermediate-2 (Score 3: n = 39), and Poor (Score 4: n = 24), respectively (P < 0.001). The predicting value of the index was confirmed in a validation cohort. Although a further validation study is warranted, the scoring index may be useful to predict survival and to identify the population with the lowest survival prior to HCT in patients with relapsed or refractory AML.

• Authors: Takayoshi Tachibana, Junya Kanda, Takuma Ishizaki, Yuho Najima, Masatsugu Tanaka, Noriko Doki, Shin-Ichiro Fujiwara, Shun-Ichi Kimura, Makoto Onizuka, Satoshi Takahashi, Takeshi Saito, Takehiko Mori, Shin Fujisawa, Emiko Sakaida, Kenji Matsumoto, Nobuyuki Aotsuka, Moritaka Goto, Reiko Watanabe, Katsuhiro Shono, Kensuke Usuki, Nobuhiro Tsukada, Heiwa Kanamori, Yoshinobu Kanda, Shinichiro Okamoto, Kanto Study, Group for Cell Therapy (KSGCT)
• Journal: Leukemia (Leukemia) Vol. 33 Issue 11 Pg. 2610-2618 (11 2019) ISSN: 1476-5551 [Electronic] England
• PMID: 31147621 (Publication Type: Journal Article, Multicenter Study)

Topics

• Adolescent
• Adult
• Aged
• Female
• Graft vs Host Disease
• Hematopoietic Stem Cell Transplantation
• Humans
• Leukemia, Myeloid, Acute (diagnosis, pathology, therapy)
• Male
• Middle Aged
• Multivariate Analysis
• Neoplasm Recurrence, Local
• Prognosis
• Remission Induction
• Retrospective Studies
• Transplantation Conditioning
• Treatment Outcome
• Young Adult