Hematopoietic Cell Transplantation Outcomes in Monosomal Karyotype Myeloid Malignancies
Por:
Pasquini, MC, Zhang, MJ, Medeiros, BC, Armand, P, Hui, ZH, Nishihori, T, Aljurf, MD, Akpek, G, Cahn, JY, Cairo, MS, Cerny, J, Copelan, EA, Deol, A, Freytes, CO, Gale, RP, Ganguly, S, George, B, Gupta, V, Hale, GA, Kamble, RT, Klumpp, TR, Lazarus, HM, Luger, SM, Liesveld, JL, Litzow, MR, Marks, DI, Martino, R, Norkin, M, Olsson, RF, Oran, B, Pawarode, A, Pulsipher, MA, Ramanathan, M, Reshef, R, Saad, AA, Saber, W, Savani, BN, Schouten, HC, Ringden, O, Tallman, MS, Uy, GL, Wood, WA, Wirk, B, Perez, WS, Batiwalla, M, Weisdorf, DJ
Publicada:
1 feb 2016
Resumen:
The presence of monosomal karyotype (MK+) in acute myeloid leukemia (AML) is associated with dismal outcomes. We evaluated the impact of MK+ in AML (MK+AML, n = 240) and in myelodysplastic syndrome (MDS) (MK+MDS, n = 221) on hematopoietic cell transplantation outcomes compared with other cytogenetically defined groups (AML, n = 3360; MDS, n = 1373) as reported to the Center for International Blood and Marrow Transplant Research from 1998 to 2011. MK+AML was associated with higher disease relapse (hazard ratio, 1.98; P < .01), similar transplantation-related mortality (TRM) (hazard ratio, 1.01; P = .90), and worse survival (hazard ratio, 1.67; P < .01) compared with those outcomes for other cytogenetically defined AML. Among patients with MDS, MK+ MDS was associated with higher disease relapse (hazard ratio, 2.39; P < .01), higher TRM (hazard ratio, 1.80; P < .01), and worse survival (HR, 2.02; P < .01). Subset analyses comparing chromosome 7 abnormalities (del7/7q) with or without MK+ demonstrated higher mortality for MK+ disease in for both AML (hazard ratio, 1.72; P < .01) and MDS (hazard ratio, 1.79; P < .01). The strong negative impact of MK+ in myeloid malignancies was observed in all age groups and using either myeloablative or reduced-intensity conditioning regimens. Alternative approaches to mitigate disease relapse in this population are needed. (C) 2016 American Society for Blood and Marrow Transplantation.
Filiaciones:
Pasquini, MC:
Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA
Zhang, MJ:
Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA
Med Coll Wisconsin, Inst Hlth & Soc, Div Biostat, Milwaukee, WI 53226 USA
Medeiros, BC:
Stanford Univ, Sch Med, Dept Hematol, Stanford, CA 94305 USA
Armand, P:
Dana Farber Canc Inst, Dept Med Oncol Hematol Malignancies, Boston, MA 02115 USA
Hui, ZH:
Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA
Nishihori, T:
H Lee Moffitt Canc Ctr & Res Inst, Dept Blood & Marrow Transplantat, Tampa, FL USA
Aljurf, MD:
King Faisal Specialist Hosp & Res Ctr, Dept Oncol, Riyadh 11211, Saudi Arabia
Akpek, G:
Banner MD Anderson Canc Ctr, Stem Cell Transplantat & Cellular Therapy Program, Gilbert, AZ USA
Cahn, JY:
Univ Hosp, Dept Hematol, Grenoble, France
Cairo, MS:
New York Med Coll, Dept Pediat, Div Pediat Hematol Oncol & Stem Cell Transplantat, Valhalla, NY 10595 USA
Cerny, J:
UMass Mem Med Ctr, Dept Med, Worcester, MA USA
Copelan, EA:
Carolinas HealthCare Syst, Levine Canc Inst, Dept Hematol Oncol & Blood Disorders, Charlotte, NC USA
Deol, A:
Wayne State Univ, Karmanos Canc Inst, Dept Oncol, Detroit, MI USA
Freytes, CO:
S Texas Vet Hlth Care Syst, Div Hematol & Oncol, San Antonio, TX USA
Univ Texas Hlth Sci Ctr San Antonio, San Antonio, TX 78229 USA
Gale, RP:
Univ London Imperial Coll Sci Technol & Med, Dept Med, Div Expt Med, Hematol Res Ctr, London, England
Ganguly, S:
Univ Kansas, Med Ctr, Div Hematol & Oncol, Blood & Marrow Transplantat, Kansas City, KS 66103 USA
George, B:
Christian Med Coll & Hosp, Dept Haematol, Vellore, Tamil Nadu, India
Gupta, V:
Univ Hlth Network, Princess Margaret Canc Ctr, Blood & Marrow Transplant Program, Toronto, ON, Canada
Hale, GA:
Univ S Florida, All Childrens Hosp, Dept Hematol Oncol, St Petersburg, FL 33701 USA
Kamble, RT:
Baylor Coll Med, Ctr Cell & Gene Therapy, Div Hematol & Oncol, Houston, TX 77030 USA
Klumpp, TR:
Thomas Jefferson Univ Hosp, Dept Med Oncol, Philadelphia, PA 19107 USA
Lazarus, HM:
Univ Hosp Case Med Ctr, Seidman Canc Ctr, Cleveland, OH USA
Luger, SM:
Univ Penn, Med Ctr, Abramson Canc Ctr, Dept Med, Philadelphia, PA 19104 USA
Liesveld, JL:
Univ Rochester, Med Ctr, Dept Med, Rochester, NY 14642 USA
Litzow, MR:
Mayo Clin, Div Hematol & Transplant Ctr, Rochester, MN USA
Marks, DI:
Univ Hosp Bristol NHS Trust, Pediat Bone Marrow Transplant, Bristol, Avon, England
Martino, R:
Hosp Santa Creu & Sant Pau, Div Clin Hematol, Barcelona, Spain
Norkin, M:
Univ Florida, Coll Med, Div Hematol Oncol, Gainesville, FL USA
Olsson, RF:
Karolinska Inst, Dept Lab Med, Div Therapeut Immunol, Stockholm, Sweden
Uppsala Univ, Ctr Clin Res Sormland, Uppsala, Sweden
Oran, B:
Univ Texas MD Anderson Canc Ctr, Dept Stem Cell Transplantat, Div Canc Med, Houston, TX 77030 USA
Pawarode, A:
Univ Michigan, Dept Internal Med, Ann Arbor, MI 48109 USA
Pulsipher, MA:
Univ So Calif, Keck Sch Med, Childrens Hosp Angeles, Div Hematol Oncol & Blood & Marrow Transplantat, Los Angeles, CA 90033 USA
Ramanathan, M:
UMass Mem Med Ctr, Dept Med, Worcester, MA USA
Reshef, R:
Univ Penn, Med Ctr, Abramson Canc Ctr, Dept Med, Philadelphia, PA 19104 USA
Saad, AA:
Univ Alabama Birmingham, Dept Med, Div Hematol Oncol, Birmingham, AL 35294 USA
Saber, W:
Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA
Savani, BN:
Vanderbilt Univ, Dept Med, Div Hematol Oncol, 221 Kirkland Hall, Nashville, TN 37235 USA
Schouten, HC:
Acad Ziekenhuis, Dept Hematol, Maastricht, Netherlands
Ringden, O:
Karolinska Inst, Dept Lab Med, Div Therapeut Immunol, Stockholm, Sweden
Ctr Allogene Stem Cell Transplantat, Stockholm, Sweden
Tallman, MS:
Mem Sloan Kettering Canc Ctr, Dept Med, Leukemia Serv, 1275 York Ave, New York, NY 10021 USA
Uy, GL:
Washington Univ, Sch Med, Div Oncol, St Louis, MO USA
Wood, WA:
Univ N Carolina, Dept Med, Div Hematol Oncol, Chapel Hill, NC USA
Wirk, B:
Seattle Canc Care Alliance, Div Bone Marrow Transplant, Seattle, WA USA
Perez, WS:
Med Coll Wisconsin, Dept Med, Ctr Int Blood & Marrow Transplant Res, Milwaukee, WI 53226 USA
Batiwalla, M:
NHLBI, NIH, Hematol Branch, Bldg 10, Bethesda, MD 20892 USA
Weisdorf, DJ:
Univ Minnesota, Med Ctr, Dept Med, Div Hematol Oncol & Transplantat, Minneapolis, MN 55455 USA
Green Accepted, Hybrid Gold
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