Impact of cytogenetic abnormalities on outcomes of adult Philadelphia-negative acute lymphoblastic leukemia after allogeneic hematopoietic stem cell transplantation: A study by the Acute Leukemia Working Committee of the Center for International Blood and Marrow Transplant Research Journal Article


Authors: Lazaryan, A.; Dolan, M.; Zhang, M. J.; Wang, H. L.; Kharfan-Dabaja, M. A.; Marks, D. I.; Bejanyan, N.; Copelan, E.; Majhail, N. S.; Waller, E. K.; Chao, N.; Prestidge, T.; Nishihori, T.; Kebriaei, P.; Inamoto, Y.; Hamilton, B.; Hashmi, S. K.; Kamble, R. T.; Bacher, U.; Hildebrandt, G. C.; Stiff, P. J.; McGuirk, J.; Aldoss, I.; Beitinjaneh, A. M.; Muffly, L.; Vij, R.; Olsson, R. F.; Byrne, M.; Schultz, K. R.; Aljurf, M.; Seftel, M.; Savoie, M. L.; Savani, B. N.; Verdonck, L. F.; Cairo, M. S.; Hossain, N.; Bhatt, V. R.; Frangoul, H. A.; Abdel-Azim, H.; Al Malki, M.; Munker, R.; Rizzieri, D.; Khera, N.; Nakamura, R.; Ringdén, O.; Van Der Poel, M.; Murthy, H. S.; Liu, H.; Mori, S.; De Oliveira, S.; Bolaños-Meade, J.; Elsawy, M.; Barba, P.; Nathan, S.; George, B.; Pawarode, A.; Grunwald, M.; Agrawal, V.; Wang, Y.; Assal, A.; Caro, P. C.; Kuwatsuka, Y.; Seo, S.; Ustun, C.; Politikos, I.; Lazarus, H. M.; Saber, W.; Sandmaier, B. M.; De Lima, M.; Litzow, M.; Bachanova, V.; Weisdorf, D.; Acute Leukemia Committee of the CIBMTR
Article Title: Impact of cytogenetic abnormalities on outcomes of adult Philadelphia-negative acute lymphoblastic leukemia after allogeneic hematopoietic stem cell transplantation: A study by the Acute Leukemia Working Committee of the Center for International Blood and Marrow Transplant Research
Abstract: Cytogenetic risk stratification at diagnosis has long been one of the most useful tools to assess prognosis in acute lymphoblastic leukemia (ALL). To examine the prognostic impact of cytogenetic abnormalities on outcomes after allogeneic hematopoietic cell transplantation, we studied 1731 adults with Philadelphia-negative ALL in complete remission who underwent myeloablative or reduced intensity/nonmyeloablative conditioning transplant from unrelated or matched sibling donors reported to the Center for International Blood and Marrow Transplant Research. A total of 632 patients had abnormal conventional metaphase cytogenetics. The leukemia-free survival and overall survival rates at 5 years after transplantation in patients with abnormal cytogenetics were 40% and 42%, respectively, which were similar to those in patients with a normal karyotype. Of the previously established cytogenetic risk classifications, modified Medical Research Council-Eastern Cooperative Oncology Group score was the only independent prognosticator of leukemia-free survival (P=0.03). In the multivariable analysis, monosomy 7 predicted post-transplant relapse [hazard ratio (HR)=2.11; 95% confidence interval (95% CI): 1.04-4.27] and treatment failure (HR=1.97; 95% CI: 1.20-3.24). Complex karyotype was prognostic for relapse (HR=1.69; 95% CI: 1.06-2.69), whereas t(8;14) predicted treatment failure (HR=2.85; 95% CI: 1.35-6.02) and overall mortality (HR=3.03; 95% CI: 1.44-6.41). This large study suggested a novel transplant-specific cytogenetic scheme with adverse [monosomy 7, complex karyotype, del(7q), t(8;14), t(11;19), del(11q), tetraploidy/near triploidy], intermediate (normal karyotype and all other abnormalities), and favorable (high hyperdiploidy) risks to prognosticate leukemia-free survival (P=0.02). Although some previously established high-risk Philadelphia-negative cytogenetic abnormalities in ALL can be overcome by transplantation, monosomy 7, complex karyotype, and t(8;14) continue to pose significant risks and yield inferior outcomes. © 2020 Ferrata Storti Foundation.
Journal Title: Haematologica
Volume: 105
Issue: 5
ISSN: 0390-6078
Publisher: Ferrata Storti Foundation  
Date Published: 2020-05-01
Start Page: 1329
End Page: 1338
Language: English
DOI: 10.3324/haematol.2019.220756
PUBMED: 31558669
PROVIDER: scopus
PMCID: PMC7193485
DOI/URL:
Notes: Article -- Export Date: 1 July 2020 -- Source: Scopus
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