Citations 1
Comparison of outcomes of HCT in blast phase of BCR-ABL1− MPN with de novo AML and with AML following MDS
Kim, Soyoung , Hu, Zhen‐Huan , Aljurf, Mahmoud , Beitinjaneh, Amer , Cahn, Jean‐Yves, Černý, Jan , Copelan, Edward A. , Gadalla, Shahinaz M. , Ganguly, Siddhartha , Hamilton, Betty K. , Hashmi, Shahrukh K. , Hildebrandt, Gerhard , Kamble, Rammurti T., Kindwall‐Keller, Tamila L. , Litzow, Mark R. , Rizzieri, David A. , Seo, Sachiko , Solh, Melhem , Verdonck, Leo F. , Wirk, Baldeep , Woolfrey, Ann E. , Alyea, Edwin P. , Sobecks, Ronald , Scott, Bart L. , Nakamura, Ryotaro , Saber, Wael , Hashmi, Shahrukh, Gadalla, Shahinaz M , Kim, Soyoung , Gupta, Vikas , Liu, Ying , Bacher, Ulrike , Cahn, Jean‐Yves , Gale, Robert Peter , George, Biju , Gerds, Aaron T. , Gergis, Usama , Lazarus, Hillard M. , Liesveld, Jane L. , Maziarz, Richard Thomas , Nishihori, Taiga , Olsson, Richard F. , Savani, Bipin N. , Szer, Jeff , Yared, Jean A. , Popat, Uday R
Blood Advances | October 2, 2020 | Volume: 4 | Issue: 19 | Pages: 4748-4757
10.1182/bloodadvances.2020002621
Abstract Comparative outcomes of allogeneic hematopoietic cell transplantation (HCT) for BCR-ABL1− myeloproliferative neoplasms (MPNs) in blast phase (MPN-BP) vs de novo acute myeloid leukemia (AML), and AML with prior myelodysplastic syndromes (MDSs; post-MDS AML), are unknown. Using the Center for International Blood and Marrow Transplant Research (CIBMTR) database, we compared HCT outcomes in 177 MPN-BP patients with 4749 patients with de novo AML, and 1104 patients with post-MDS AML, using multivariate regression analysis in 2 separate comparisons. In a multivariate Cox model, no difference in overall survival (OS) or relapse was observed in patients with MPN-BP vs de novo AML with active leukemia at HCT. Patients with MPN-BP in remission had inferior OS in comparison with de novo AML in remission (hazard ratio [HR], 1.40 [95% confidence interval [CI], 1.12-1.76]) due to higher relapse rate (HR, 2.18 [95% CI, 1.69-2.80]). MPN-BP patients had inferior OS (HR, 1.19 [95% CI, 1.00-1.43]) and increased relapse (HR, 1.60 [95% CI, 1.31-1.96]) compared with post-MDS AML. Poor-risk cytogenetics were associated with increased relapse in both comparisons. Peripheral blood grafts were associated with decreased relapse in MPN-BP and post-MDS AML (HR, 0.70 [95% CI, 0.57-0.86]). Nonrelapse mortality (NRM) was similar between MPN-BP vs de novo AML, and MPN-BP vs post-MDS AML. Total-body irradiation–based myeloablative conditioning was associated with higher NRM in both comparisons. Survival of MPN-BP after HCT is inferior to de novo AML in remission and post-MDS AML due to increased relapse. Relapse-prevention strategies are required to optimize HCT outcomes in MPN-BP.