Researchers at the University of Toronto have investigated the predictive outcomes in patients with therapy-related acute myeloid leukemia (t-AML) who have received allogeneic hematopoietic stem cell transplantation (allo-HSCT). Published in Hematology Oncology and Stem Cell Therapy, the authors performed a retrospective study in patients with t-AML who underwent allo-HSCT, finding several predictors of overall survival.
Cancer patients can experience t-AML, a complication that results in cytogenetic abnormalities following chemotherapy and/or radiotherapy. Patients who develop t-AML following chemotherapy have a poor prognosis, with allo-HSCT used as a treatment. Current literature on allo-HSCT and t-AML is confounded by the inclusion of therapy-related myelodysplasia (t-MDS) and/or secondary AML.
The goal of this study was to delineate the predictors of allo-HSCT outcomes in adults with t-AML. Among the 68 patients (59.9% female; median age, 56.5 years) who underwent HSCT, acute and chronic graft-versus-host disease (GVHD) occurred in 39 (57.4%) and 23 (33.8%) patients, respectively. Predictors found to reduce overall survival included: 11q23 rearrangement, treatment regimens other than FLAG-IDA or 7 + 3 therapy, haploidentical donors, ECOG performance status 2 or higher, and using cyclosporine A–methotrexate. Although further studies are required, these findings provide insight into potential predictors of overall survival in t-AML post allo-HSCT.
Ram Vasudevan Nampoothiri, Arjun Datt Law, Wilson Lam, Carol Chen, Zeyad Al-Shaibani, David Loach, Fotios V. Michelis, Dennis (Dong Hwan) Kim, Jonas Mattsson, Rajat Kumar, Jeffrey Howard Lipton, Auro Viswabandya.Predictors of outcomes of therapy-related acute myeloid leukemia after allogeneic hematopoietic stem cell transplantation. Hematol Oncol Stem Cell Ther. 2021.