Rapid Donor Identification Improves Survival in High-Risk First-Remission Patients With Acute Myeloid Leukemia.
JCO Oncol Pract
PURPOSE: Patients with acute myeloid leukemia with high-risk cytogenetics in first complete remission (CR1) achieve better outcomes if they undergo allogeneic hematopoietic cell transplantation (HCT) compared with consolidation chemotherapy alone. However, only approximately 40% of such patients typically proceed to HCT.
METHODS: We used a prospective organized approach to rapidly identify donors to improve the allogeneic HCT rate in adults with high-risk acute myeloid leukemia in CR1. Newly diagnosed patients had cytogenetics obtained at enrollment, and those with high-risk cytogenetics underwent expedited HLA typing and were encouraged to be referred for consultation with a transplantation team with the goal of conducting an allogeneic HCT in CR1.
RESULTS: Of 738 eligible patients (median age, 49 years; range, 18-60 years of age), 159 (22%) had high-risk cytogenetics and 107 of these patients (67%) achieved CR1. Seventy (65%) of the high-risk patients underwent transplantation in CR1 (
CONCLUSION: Early cytogenetic testing with an organized effort to identify a suitable allogeneic HCT donor led to a CR1 transplantation rate of 65% in the high-risk group, which, in turn, led to an improvement in OS when compared with the OS of patients who did not undergo transplantation.
Pagel, John M; Othus, Megan; Garcia-Manero, Guillermo; Fang, Min; Radich, Jerald P; Rizzieri, David A; Marcucci, Guido; Strickland, Stephen A; Litzow, Mark R; Savoie, M Lynn; Spellman, Stephen R; Confer, Dennis L; Chell, Jeffrey W; Brown, Maria; Medeiros, Bruno C; Sekeres, Mikkael A; Lin, Tara L; Uy, Geoffrey L; Powell, Bayard L; Bayer, Ruthee-Lu; Larson, Richard A; Stone, Richard M; Claxton, David; Essell, James; Luger, Selina M; Mohan, Sanjay R; Moseley, Anna; Erba, Harry P; and Appelbaum, Frederick R, "Rapid Donor Identification Improves Survival in High-Risk First-Remission Patients With Acute Myeloid Leukemia." (2020). Articles, Abstracts, and Reports. 2865.