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Monosomal karyotype affecting outcomes of allogeneic hematopoietic stem cell transplantation for acute myeloid leukemia in first complete remission
Author(s) -
Choi Yunsuk,
Lee JeHwan,
Lee JungHee,
Park HanSeung,
Choi EunJi,
Jo JaeCheol,
Lee Yoo Jin,
Lee YoungShin,
Kang YoungAh,
Lee KyooHyung
Publication year - 2020
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.13434
Subject(s) - medicine , cumulative incidence , hazard ratio , hematopoietic stem cell transplantation , myeloid leukemia , transplantation , oncology , npm1 , incidence (geometry) , multivariate analysis , gastroenterology , karyotype , confidence interval , biology , biochemistry , physics , optics , chromosome , gene
Objectives We evaluated the prognostic impact of MK on postremission outcomes of AML patients receiving allogeneic hematopoietic stem cell transplantation (HSCT) in the first complete remission (CR1). Methods We retrospectively analyzed 465 adult patients with AML who had received HSCT in the first CR between 2000 and 2016. Results In MK + AML, the median leukocyte count was significantly lower ( P < .001) and no NPM1 mutation was found ( P = .042). Multivariate analysis revealed that MK was the most powerful prognostic factors for OS (hazard ratio [HR], 2.6; P = .001), EFS (HR, 3.8; P < .001), and cumulative incidence of relapse (HR, 6.1; P < .001), compared to any other poor risk factors such as complex karyotype, FLT3‐ITD mutations, old age, and higher leukocyte count. The adverse prognostic impact of MK tended to be more prominent in the younger age group (<40 years) (HR, 6.3, P < .001) than in the older age group (≥40 years) (HR, 3.4, P < .001). Conclusion Novel treatment modalities for MK + AML need to be investigated to reduce the risk of relapse after HSCT.