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Impact of FAB classification on predicting outcome in acute myeloid leukemia, not otherwise specified, patients undergoing allogeneic stem cell transplantation in CR 1: An analysis of 1690 patients from the acute leukemia working party of EBMT
Author(s) -
Canaani Jonathan,
Beohou Eric,
Labopin Myriam,
Socié Gerard,
Huynh Anne,
Volin Liisa,
Cornelissen Jan,
Milpied Noel,
GeddeDahl Tobias,
Deconinck Eric,
Fegueux Nathalie,
Blaise Didier,
Mohty Mohamad,
Nagler Ar
Publication year - 2017
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.24640
Subject(s) - medicine , npm1 , hazard ratio , myeloid leukemia , transplantation , multivariate analysis , oncology , myeloid , cohort , confidence interval , leukemia , hematopoietic stem cell transplantation , biology , biochemistry , gene , karyotype , chromosome
The French, American, and British (FAB) classification system for acute myeloid leukemia (AML) is extensively used and is incorporated into the AML, not otherwise specified (NOS) category in the 2016 WHO edition of myeloid neoplasm classification. While recent data proposes that FAB classification does not provide additional prognostic information for patients for whom NPM1 status is available, it is unknown whether FAB still retains a current prognostic role in predicting outcome of AML patients undergoing allogeneic stem cell transplantation. Using the European Society of Blood and Bone Marrow Transplantation registry we analyzed outcome of 1690 patients transplanted in CR1 to determine if FAB classification provides additional prognostic value. Multivariate analysis revealed that M6/M7 patients had decreased leukemia free survival (hazard ratio (HR) of 1.41, 95% confidence interval (CI), 1.01–1.99; P = .046) in addition to increased nonrelapse mortality (NRM) rates (HR, 1.79; 95% CI, 1.06–3.01; P = .028) compared with other FAB types. In the NPM1 wt AML, NOS cohort, FAB M6/M7 was also associated with increased NRM (HR, 2.17; 95% CI, 1.14–4.16; P = .019). Finally, in FLT3‐ITD + patients, multivariate analyses revealed that specific FAB types were tightly associated with adverse outcome. In conclusion, FAB classification may predict outcome following transplantation in AML, NOS patients.