TY  - JOUR
AU  - Gupta, V
AU  - Kim, S
AU  - Hu, Z-H
AU  - Liu, Y
AU  - Aljurf, M
AU  - Bacher, U
AU  - Beitinjaneh, A
AU  - Cahn, J-Y
AU  - Cerny, J
AU  - Copelan, E
AU  - Gadalla, SM
AU  - Gale, RP
AU  - Ganguly, S
AU  - George, B
AU  - Gerds, AT
AU  - Gergis, U
AU  - Hamilton, BK
AU  - Hashmi, S
AU  - Hildebrandt, GC
AU  - Kamble, RT
AU  - Kindwall-Keller, T
AU  - Lazarus, HM
AU  - Liesveld, JL
AU  - Litzow, M
AU  - Maziarz, RT
AU  - Nishihori, T
AU  - Olsson, RF
AU  - Rizzieri, D
AU  - Savani, BN
AU  - Seo, S
AU  - Solh, M
AU  - Szer, J
AU  - Verdonck, LF
AU  - Wirk, B
AU  - Woolfrey, A
AU  - Yared, JA
AU  - Alyea, EP
AU  - Popat, UR
AU  - Sobecks, RM
AU  - Scott, BL
AU  - Nakamura, R
AU  - Saber, W
Y2  - 2020/12/14
Y1  - 2020/10/13
SN  - 2473-9529
UR  - http://hdl.handle.net/11343/254276
AB  - 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.
LA  - English
PB  - AMER SOC HEMATOLOGY
T1  - Comparison of outcomes of HCT in blast phase of BCR-ABL1(-) MPN with de novo AML and with AML following MDS
DO  - 10.1182/bloodadvances.2020002621
IS  - Blood Advances
VL  - 4
IS  - 19
SP  - 4748-4757
ER  -