TY - JOUR
T1 - Impact of measurable residual disease on outcomes of unrelated donor haematopoietic cell transplantation with post-transplant cyclophosphamide in AML in first complete remission
AU - Nagler, Arnon
AU - Labopin, Myriam
AU - Dholaria, Bhagirathbhai
AU - Blaise, Didier
AU - Bondarenko, Sergey
AU - Vydra, Jan
AU - Choi, Goda
AU - Rovira, Montserrat
AU - Reményi, P. ter
AU - Meijer, Ellen
AU - Bulabois, Claude Eric
AU - Diez-Martin, J. L.
AU - Yakoub-Agha, Ibrahim
AU - Brissot, Eolia
AU - Spyridonidis, Alexandros
AU - Sanz, Jaime
AU - Patel, Amit
AU - Arat, Mutlu
AU - Bazarbachi, Ali
AU - Bug, Gesine
AU - Savani, Bipin N.
AU - Giebel, Sebastian
AU - Ciceri, Fabio
AU - Mohty, Mohamad
N1 - Funding Information: We thank all the European Society for Blood and Marrow Transplantation (EBMT) centres and national registries for contributing patients to this study (Table S1). We also thank the data managers for their excellent work and the patients who contributed their data. Publisher Copyright: © 2023 British Society for Haematology and John Wiley & Sons Ltd.
PY - 2023/6
Y1 - 2023/6
N2 - Pre-transplant measurable residual disease (MRD) predicts relapse and outcome of allogeneic haematopoietic cell transplantation (allo-HCT). The impact of MRD on the outcomes of post-transplant cyclophosphamide (PTCy)-based allo-HCT from a matched unrelated donor (UD) is unknown. This study assessed the impact of MRD in acute myeloid leukaemia (AML) in the first complete remission (CR1). A total of 272 patients (MRD negative [MRD−], n = 165; MRD positive [MRD+], n = 107) with a median follow-up of 19 (range: 16–24) months were studied. The incidence of grades II–IV and grades III–IV acute GVHD at day 180 was 25.2% and 25% (p = 0.99), and 10.6% and 6.8% (p = 0.29), respectively, and 2-year chronic GVHD was 35% and 30.4% (p = 0.96) in MRD+ and MRD− cohorts, respectively. In multivariate analysis, MRD+ status was associated with a higher incidence of relapse (RI) (hazard ratio [HR] = 2.56, 95% CI: 1.39–4.72), lower leukaemia-free survival (LFS) (HR = 2.04, 95% CI: 1.23–3.39), overall survival (OS) (HR = 1.83, 95% CI: 1.04–3.25) and GVHD-free, relapse-free survival (GRFS) (HR = 1.69, 95% CI: 1.10–2.58). MRD status did not have a significant impact on non-relapse mortality (NRM), or acute or chronic GVHD risk. Among patients with AML undergoing UD allo-HCT with PTCy, pre-transplant MRD+ status predicted a higher relapse rate, lower LFS, OS and GRFS.
AB - Pre-transplant measurable residual disease (MRD) predicts relapse and outcome of allogeneic haematopoietic cell transplantation (allo-HCT). The impact of MRD on the outcomes of post-transplant cyclophosphamide (PTCy)-based allo-HCT from a matched unrelated donor (UD) is unknown. This study assessed the impact of MRD in acute myeloid leukaemia (AML) in the first complete remission (CR1). A total of 272 patients (MRD negative [MRD−], n = 165; MRD positive [MRD+], n = 107) with a median follow-up of 19 (range: 16–24) months were studied. The incidence of grades II–IV and grades III–IV acute GVHD at day 180 was 25.2% and 25% (p = 0.99), and 10.6% and 6.8% (p = 0.29), respectively, and 2-year chronic GVHD was 35% and 30.4% (p = 0.96) in MRD+ and MRD− cohorts, respectively. In multivariate analysis, MRD+ status was associated with a higher incidence of relapse (RI) (hazard ratio [HR] = 2.56, 95% CI: 1.39–4.72), lower leukaemia-free survival (LFS) (HR = 2.04, 95% CI: 1.23–3.39), overall survival (OS) (HR = 1.83, 95% CI: 1.04–3.25) and GVHD-free, relapse-free survival (GRFS) (HR = 1.69, 95% CI: 1.10–2.58). MRD status did not have a significant impact on non-relapse mortality (NRM), or acute or chronic GVHD risk. Among patients with AML undergoing UD allo-HCT with PTCy, pre-transplant MRD+ status predicted a higher relapse rate, lower LFS, OS and GRFS.
KW - acute myeloid leukaemia
KW - allogeneic haematopoietic cell transplantation
KW - measurable residual disease
KW - post-transplant cyclophosphamide
KW - unrelated donor
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85150895781&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/36949658
U2 - https://doi.org/10.1111/bjh.18765
DO - https://doi.org/10.1111/bjh.18765
M3 - Article
C2 - 36949658
SN - 0007-1048
VL - 201
SP - 1169
EP - 1178
JO - British journal of haematology
JF - British journal of haematology
IS - 6
ER -