Authors

Vikas Gupta, Princess Margaret Cancer Centre
Soyoung Kim, Medical College of Wisconsin
Zhen-Huan Hu, Medical College of Wisconsin
Ying Liu, Columbia University Irving Medical Center
Mahmoud Aljurf, King Faisal Specialist Hospital Center and Research Center
Ulrike Bacher, University of Bern
Amer Beitinjaneh, University of Miami
Jean-Yves Cahn, Centre Hospitalier Universitaire (CHU) Grenoble Alpes
Jan Cerny, University of Massachusetts Medical Center
Edward Copelan, Levine Cancer Institute
Shahinaz M Gadalla, National Institutes of Health
Robert Peter Gale, Imperial College London
Siddhartha Ganguly, University of Kansas Health System
Biju George, Christian Medical College
Aaron T Gerds, Taussig Cancer Institute
Usama Gergis, Thomas Jefferson UniversityFollow
Betty K Hamilton, Cleveland Clinic Taussig Cancer Institute
Shahrukh Hashmi, Mayo Clinic
Gerhard C Hildebrandt, University of Kentucky
Rammurti T Kamble, Baylor University
Tamila Kindwall-Keller, University of Virginia Health System
Hillard M Lazarus, Case Western Reserve University
Jane L Liesveld, University of Rochester Medical Center
Mark Litzow, Mayo Clinic Rochester
Richard T Maziarz, Oregon Health and Science University
Taiga Nishihori, Moffitt Cancer Center
Richard F Olsson, Uppsala University
David Rizzieri, Duke University
Bipin N Savani, Vanderbilt University Medical Center
Sachiko Seo, Dokkyo Medical University
Melhem Solh, Northside Hospital
Jeff Szer, Peter MacCallum Cancer Centre/The Royal Melbourne Hospital
Leo F Verdonck, Isala Clinic
Baldeep Wirk, Penn State Cancer Institute
Ann Woolfrey, Fred Hutchinson Cancer Research Center
Jean A Yared, University of Maryland
Edwin P Alyea, Dana-Farber Cancer Institute
Uday R Popat, The University of Texas MD Anderson Cancer Center
Ronald M Sobecks, Cleveland Clinic
Bart L Scott, Fred Hutchinson Cancer Research Center
Ryotaro Nakamura, Department of Hematology and Hematopoietic Cell Transplantation
Wael Saber, Medical College of Wisconsin

Document Type

Article

Publication Date

10-13-2020

Comments

This article is the author’s final published version in Blood Advances, Volume 4, Issue 19, October 2020, Pages 4748-4757.

The published version is available at https://doi.org/10.1182/bloodadvances.2020002621. Copyright © American Society of Hematology

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.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.

PubMed ID

33007075

Language

English

Included in

Oncology Commons

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