Allogeneic Hematopoietic Cell Transplantation in Intermediate Risk Acute Myeloid Leukemia negative for FLT3-ITD, NPM1- or biallelic CEBPA Mutations

Heidrich K, Thiede C, Schaefer-Eckart K, Schmitz N, Aulitzky WE, Kraemer A, Rösler W, Haenel M, Einsele H, Baldus CD, Trappe RU, Stoelzel F, Middeke JM, Roellig C, Taube F, Kramer M, Serve H, Berdel WE, Ehninger G, Bornhaeuser M, Schetelig J (2017)

Publication Type: Journal article

Publication year: 2017

Journal

Annals of Oncology Elsevier

DOI: 10.1093/annonc/mdx500

Abstract

The value of allogeneic hematopoietic cell transplantation (alloHCT) as post-remission treatment is not well defined for patients with intermediate-risk acute myeloid leukemia (AML) without FLT3 -ITD, biallelic CEBPA -, or NPM1 mutations (here referred to as NPM1 mut-neg / CEBPA dm-neg / FLT3 -ITD neg AML) in first complete remission (CR1).We addressed this question using data from two prospective randomized controlled trials on intensive induction- and risk-stratified post-remission therapy The NPM1 mut-neg / CEBPA dm-neg / FLT3 -ITD neg AML subgroup comprised 497 patients, aged 18-60 years.In donor versus no-donor analyses, patients with a matched related donor had a longer relapse-free survival (RFS) (HR 0.5; 95%-CI, 0.3 - 0.9, p = .02) and a trend towards better overall survival (OS) (HR 0.6, 95%-CI, 0.3 - 1.1, p = .08) compared to patients who received post-remission chemotherapy. Notably, only 58% of patients in the donor group were transplanted in CR1. We therefore complemented the donor versus no-donor analysis with multivariable Cox regression analyses, where alloHCT was tested as a time-dependent covariate: OS (HR 0.58, 95%-CI, 0.37 - 0.9, p = .02) and RFS (HR 0.51; 95%-CI, 0.34 - 0.76; p = .001) for patients who received alloHCT compared to chemotherapy in CR1 were significantly longer.Outside clinical trials, alloHCT should be the preferred post-remission treatment for patients with intermediate risk NPM1 mut-neg /CEBPA dm-neg /FLT3-ITD neg AML in CR1.

Authors with CRIS profile

Wolf Rösler Department of Medicine 5 – Haematology and Oncology

Involved external institutions

DIAKO Evangelisches Diakonie-Krankenhaus gGmbH DE Germany (DE) Technische Universität Dresden DE Germany (DE) Universitätsklinikum Würzburg DE Germany (DE) Universitätsklinikum Münster DE Germany (DE) Charité - Universitätsmedizin Berlin DE Germany (DE) Universitätsklinikum Frankfurt am Main (KGU) DE Germany (DE) Klinikum Chemnitz DE Germany (DE) Universitätsklinikum Heidelberg DE Germany (DE) Robert-Bosch-Krankenhaus DE Germany (DE) Asklepios Kliniken Verwaltungsgesellschaft mbH DE Germany (DE) Paracelsus Medizinische Privatuniversität AT Austria (AT)

How to cite

APA:

Heidrich, K., Thiede, C., Schaefer-Eckart, K., Schmitz, N., Aulitzky, W.E., Kraemer, A.,... Schetelig, J. (2017). Allogeneic Hematopoietic Cell Transplantation in Intermediate Risk Acute Myeloid Leukemia negative for FLT3-ITD, NPM1- or biallelic CEBPA Mutations. Annals of Oncology. https://dx.doi.org/10.1093/annonc/mdx500

MLA:

Heidrich, K., et al. "Allogeneic Hematopoietic Cell Transplantation in Intermediate Risk Acute Myeloid Leukemia negative for FLT3-ITD, NPM1- or biallelic CEBPA Mutations." Annals of Oncology (2017).

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