Comparison of outcomes of HCT in blast phase of BCR-ABL12 MPN with de novo AML and with AML following MDS

Vikas Gupta; Soyoung Kim; Zhen Huan Hu; Ying Liu; Mahmoud Aljurf; Ulrike Bacher; Amer Beitinjaneh; Jean Yves Cahn; Jan Cerny; Edward Copelan; Shahinaz M. Gadalla; Robert Peter Gale; Siddhartha Ganguly; Biju George; Aaron T. Gerds; Usama Gergis; Betty K. Hamilton; Shahrukh Hashmi; Gerhard C. Hildebrandt; Rammurti T. Kamble; Tamila Kindwall-Keller; Hillard M. Lazarus; Jane L. Liesveld; Mark Litzow; Richard T. Maziarz; Taiga Nishihori; Richard F. Olsson; David Rizzieri; Bipin N. Savani; Sachiko Seo; Melhem Solh; Jeff Szer; Leo F. Verdonck; Baldeep Wirk; Ann Woolfrey; Jean A. Yared; Edwin P. Alyea; Uday R. Popat; Ronald M. Sobecks; Bart L. Scott; Ryotaro Nakamura; Wael Saber

doi:10.1182/bloodadvances.2020002621

Comparison of outcomes of HCT in blast phase of BCR-ABL1² MPN with de novo AML and with AML following MDS

Vikas Gupta, Soyoung Kim, Zhen Huan Hu, Ying Liu, Mahmoud Aljurf, Ulrike Bacher, Amer Beitinjaneh, Jean Yves Cahn, Jan Cerny, Edward Copelan, Shahinaz M. Gadalla, Robert Peter Gale, Siddhartha Ganguly, Biju George, Aaron T. Gerds, Usama Gergis, Betty K. Hamilton, Shahrukh Hashmi, Gerhard C. Hildebrandt, Rammurti T. KambleTamila Kindwall-Keller, Hillard M. Lazarus, Jane L. Liesveld, Mark Litzow, Richard T. Maziarz, Taiga Nishihori, Richard F. Olsson, David Rizzieri, Bipin N. Savani, Sachiko Seo, Melhem Solh, Jeff Szer, Leo F. Verdonck, Baldeep Wirk, Ann Woolfrey, Jean A. Yared, Edwin P. Alyea, Uday R. Popat, Ronald M. Sobecks, Bart L. Scott, Ryotaro Nakamura, Wael Saber

Research output: Contribution to journal › Article › peer-review

17 Scopus citations

Abstract

Comparative outcomes of allogeneic hematopoietic cell transplantation (HCT) for BCR-ABL1² 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.

Original language	English
Pages (from-to)	4748-4757
Number of pages	10
Journal	Blood advances
Volume	4
Issue number	19
DOIs	https://doi.org/10.1182/bloodadvances.2020002621
State	Published - Oct 13 2020

Bibliographical note

Publisher Copyright:
© 2020 American Society of Hematology. All rights reserved.

ASJC Scopus subject areas

Hematology

Access to Document

10.1182/bloodadvances.2020002621

Cite this

Gupta, V., Kim, S., Hu, Z. H., Liu, Y., Aljurf, M., Bacher, U., Beitinjaneh, A., Cahn, J. Y., Cerny, J., Copelan, E., Gadalla, S. M., Gale, R. P., Ganguly, S., George, B., Gerds, A. T., Gergis, U., Hamilton, B. K., Hashmi, S., Hildebrandt, G. C., ... Saber, W. (2020). Comparison of outcomes of HCT in blast phase of BCR-ABL1² MPN with de novo AML and with AML following MDS. Blood advances, 4(19), 4748-4757. https://doi.org/10.1182/bloodadvances.2020002621

@article{9fd68c5cdcc34daaa7831d0091ab99ae,

title = "Comparison of outcomes of HCT in blast phase of BCR-ABL12 MPN with de novo AML and with AML following MDS",

abstract = "Comparative outcomes of allogeneic hematopoietic cell transplantation (HCT) for BCR-ABL12 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.",

author = "Vikas Gupta and Soyoung Kim and Hu, {Zhen Huan} and Ying Liu and Mahmoud Aljurf and Ulrike Bacher and Amer Beitinjaneh and Cahn, {Jean Yves} and Jan Cerny and Edward Copelan and Gadalla, {Shahinaz M.} and Gale, {Robert Peter} and Siddhartha Ganguly and Biju George and Gerds, {Aaron T.} and Usama Gergis and Hamilton, {Betty K.} and Shahrukh Hashmi and Hildebrandt, {Gerhard C.} and Kamble, {Rammurti T.} and Tamila Kindwall-Keller and Lazarus, {Hillard M.} and Liesveld, {Jane L.} and Mark Litzow and Maziarz, {Richard T.} and Taiga Nishihori and Olsson, {Richard F.} and David Rizzieri and Savani, {Bipin N.} and Sachiko Seo and Melhem Solh and Jeff Szer and Verdonck, {Leo F.} and Baldeep Wirk and Ann Woolfrey and Yared, {Jean A.} and Alyea, {Edwin P.} and Popat, {Uday R.} and Sobecks, {Ronald M.} and Scott, {Bart L.} and Ryotaro Nakamura and Wael Saber",

year = "2020",

month = oct,

day = "13",

doi = "10.1182/bloodadvances.2020002621",

language = "English",

volume = "4",

pages = "4748--4757",

number = "19",

}

Gupta, V, Kim, S, Hu, ZH, Liu, Y, Aljurf, M, Bacher, U, Beitinjaneh, A, Cahn, JY, Cerny, J, Copelan, E, Gadalla, SM, Gale, RP, Ganguly, S, George, B, Gerds, AT, Gergis, U, Hamilton, BK, Hashmi, S, Hildebrandt, GC, Kamble, RT, Kindwall-Keller, T, Lazarus, HM, Liesveld, JL, Litzow, M, Maziarz, RT, Nishihori, T, Olsson, RF, Rizzieri, D, Savani, BN, Seo, S, Solh, M, Szer, J, Verdonck, LF, Wirk, B, Woolfrey, A, Yared, JA, Alyea, EP, Popat, UR, Sobecks, RM, Scott, BL, Nakamura, R & Saber, W 2020, 'Comparison of outcomes of HCT in blast phase of BCR-ABL1² MPN with de novo AML and with AML following MDS', Blood advances, vol. 4, no. 19, pp. 4748-4757. https://doi.org/10.1182/bloodadvances.2020002621

TY - JOUR

T1 - Comparison of outcomes of HCT in blast phase of BCR-ABL12 MPN with de novo AML and with AML following MDS

AU - Gupta, Vikas

AU - Kim, Soyoung

AU - Hu, Zhen Huan

AU - Liu, Ying

AU - Aljurf, Mahmoud

AU - Bacher, Ulrike

AU - Beitinjaneh, Amer

AU - Cahn, Jean Yves

AU - Cerny, Jan

AU - Copelan, Edward

AU - Gadalla, Shahinaz M.

AU - Gale, Robert Peter

AU - Ganguly, Siddhartha

AU - George, Biju

AU - Gerds, Aaron T.

AU - Gergis, Usama

AU - Hamilton, Betty K.

AU - Hashmi, Shahrukh

AU - Hildebrandt, Gerhard C.

AU - Kamble, Rammurti T.

AU - Kindwall-Keller, Tamila

AU - Lazarus, Hillard M.

AU - Liesveld, Jane L.

AU - Litzow, Mark

AU - Maziarz, Richard T.

AU - Nishihori, Taiga

AU - Olsson, Richard F.

AU - Rizzieri, David

AU - Savani, Bipin N.

AU - Seo, Sachiko

AU - Solh, Melhem

AU - Szer, Jeff

AU - Verdonck, Leo F.

AU - Wirk, Baldeep

AU - Woolfrey, Ann

AU - Yared, Jean A.

AU - Alyea, Edwin P.

AU - Popat, Uday R.

AU - Sobecks, Ronald M.

AU - Scott, Bart L.

AU - Nakamura, Ryotaro

AU - Saber, Wael

PY - 2020/10/13

Y1 - 2020/10/13

N2 - Comparative outcomes of allogeneic hematopoietic cell transplantation (HCT) for BCR-ABL12 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.

AB - Comparative outcomes of allogeneic hematopoietic cell transplantation (HCT) for BCR-ABL12 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.

UR - http://www.scopus.com/inward/record.url?scp=85092401454&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85092401454&partnerID=8YFLogxK

U2 - 10.1182/bloodadvances.2020002621

DO - 10.1182/bloodadvances.2020002621

M3 - Article

C2 - 33007075

AN - SCOPUS:85092401454

SN - 2473-9529

VL - 4

SP - 4748

EP - 4757

JO - Blood advances

JF - Blood advances

IS - 19

ER -