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Pre-transplant detectable measurable residual disease (MRD) is still associated with high risk of relapse and poor outcomes in acute myeloid leukemia (AML). We aimed at evaluating the impact of disease burden on prediction of relapse and survival in patients receiving allogeneic hematopoietic cell transplantation (allo-HCT) in first remission (CR1). We identified a total of 3202 adult AML patients, of these 1776 patients were in CR1 and MRD positive and 1426 patients were primary refractory at time of transplant. After a median follow-up of 24.4 months, non-relapse mortality and relapse rate were significantly higher in the primary refractory group compared to the CR1 MRD positive group (Hazards Ratio (HR) = 1.82 (95% CI: 1.47-2.24) p < 0.001 and HR = 1.54 (95% CI: 1.34-1.77), p < 0.001), respectively. Leukemia-free survival (LFS) and overall survival (OS) were significantly worse in the primary refractory group (HR = 1.61 (95% CI: 1.44-1.81), p < 0.001 and HR = 1.71 (95% CI: 1.51-1.94), p < 0.001, respectively). Our real-life data suggest that patients in CR1 and MRD positive at time of transplant could still be salvaged by allo-HCT with a 2-year OS of 63%, if negative MRD cannot be obtained and their outcomes are significantly better than patients transplanted with active disease.

Titel:	Impact of disease burden on clinical outcomes of AML patients receiving allogeneic hematopoietic cell transplantation: a study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation.
Autor/in / Beteiligte Person:	Abou Dalle, I ; Labopin, M ; Kröger, N ; Schroeder, T ; Finke, J ; Stelljes, M ; Neubauer, A ; Blaise, D ; Yakoub-Agha, I ; Salmenniemi, U ; Forcade, E ; Itäla-Remes, M ; Dreger, P ; Bug, G ; Passweg, J ; Heuser, M ; Choi, G ; Brissot, E ; Giebel, S ; Nagler, A ; Ciceri, F ; Bazarbachi, A ; Mohty, M
Link:	View record at Springer (Volltext)
Zeitschrift:	Bone marrow transplantation, Jg. 58 (2023-07-01), Heft 7, S. 784-790
Veröffentlichung:	<2003->: London : Nature Publishing Group ; <i>Original Publication</i>: Basingstoke, Hampshire : Scientific & Medical Division, Macmillan Press, c1986-, 2023
Medientyp:	academicJournal
ISSN:	1476-5365 (electronic)
DOI:	10.1038/s41409-023-01961-1
Schlagwort:	Adult Humans Bone Marrow Transplantation, Homologous Recurrence Neoplasm, Residual Cost of Illness Retrospective Studies Hematopoietic Stem Cell Transplantation adverse effects Leukemia, Myeloid, Acute
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article Language: English [Bone Marrow Transplant] 2023 Jul; Vol. 58 (7), pp. 784-790. <i>Date of Electronic Publication: </i>2023 Apr 11. MeSH Terms: Hematopoietic Stem Cell Transplantation* / adverse effects ; Leukemia, Myeloid, Acute* ; Adult ; Humans ; Bone Marrow ; Transplantation, Homologous ; Recurrence ; Neoplasm, Residual ; Cost of Illness ; Retrospective Studies References: Döhner H, Estey E, Grimwade D, Amadori S, Appelbaum FR, Büchner T, et al. Diagnosis and management of AML in adults: 2017 ELN recommendations from an international expert panel. Blood. 2017;129:424–47. https://doi.org/10.1182/blood-2016-08-733196 . (PMID: 10.1182/blood-2016-08-733196278950585291965) ; Heuser M, Freeman SD, Ossenkoppele GJ, Buccisano F, Hourigan CS, Ngai LL, et al. 2021 Update on MRD in acute myeloid leukemia: a consensus document from the European LeukemiaNet MRD Working Party. 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Impact of disease burden on clinical outcomes of AML patients receiving allogeneic hematopoietic cell transplantation: a study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation.