Abstract
The impact of risk-related parameters has not been defined in transplant settings.
We analyzed the data of 255 consecutive patients (median age: 26) with acute myeloid leukemia (AML) in their first or second remission (CR1 or CR2) after haploidentical hematopoietic stem cell transplantation (HSCT).
Three parameters were found to be predictive of outcome: response after induction therapy, WBC count at diagnosis, and cytogenetics. These three factors were combined to yield two risk groups. The 2-year cumulative incidences of relapse for patients at low and high risk were 8% and 36% (p = 0.001), respectively. The three-year probabilities of leukemia-free survival (LFS) for these two groups were 80% and 52% (p = 0.001), respectively. Multivariate analysis for relapse and for LFS showed that not achieving CR after 2 courses of therapy was the strongest independent prognostic factor (p=0.001, and p=0.019, respectively). In addition, in a subgroup of patients with quantification of minimal residual disease (MRD) at the time of HSCT, positive MRD at this time point was correlated with a poor outcome.
Our results suggest that the index is simple and predictive, so it might be applied to assist with risk-directed post-transplant therapy for young patients with AML in CR who have received myeloablative haploidentical HSCT.
Probability of leukemia-free survival with respect to risk group after haploidentical HSCT (p =0.004)
Probability of leukemia-free survival with respect to risk group after haploidentical HSCT (p =0.004)
No relevant conflicts of interest to declare.
![](https://ash.silverchair-cdn.com/ash/content_public/journal/blood/120/21/10.1182_blood.v120.21.3066.3066/6/m_permbld2011abs03.jpeg?Expires=1722725291&Signature=UGuhGFKlIXfLKEQxEr8KcUG6Fo4wJO9SSXma6cCb7teAeQvdTPl0idSfDKzK5hCLt2olssASLGRAqD1SM5rmJ6XyzyncYCj8vCg4Oo-8WM~eKjb~Mv0BvCtfryOvh9X0vACBS1YVqIce-sQRWZuPLC8bt8wgHs-c9MUYUJx8~WyBvAySmEG3WIb6cA32eVs4rfq4B0JWbaPErLr5-Df~07PuwqjLixf3zusfKfJYLC5tn6ImJUugFOeuNEEoZ2lTxg5WWuRfgKaf6Qp9C4Uh5Xb5rNxdw7lIKnR-PVqUhrCcNf-sPYwewEA6JVt8ENlsmNI~VZfSGDlT16YUxP0ksw__&Key-Pair-Id=APKAIE5G5CRDK6RD3PGA)
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