Stratification of de novo Adult Acute Myelogenous Leukemia with Adverse-Risk Karyotype: Can We Overcome the Worse Prognosis of Adverse-Risk Group Acute.

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Presentation transcript:

Stratification of de novo Adult Acute Myelogenous Leukemia with Adverse-Risk Karyotype: Can We Overcome the Worse Prognosis of Adverse-Risk Group Acute Myelogenous Leukemia with Hematopoietic Stem Cell Transplantation? Jae-Ho Yoon, Hee-Je Kim, Seung-Hwan Shin, Sung-Eun Lee, Byung-Sik Cho, Ki-Seong Eom, Yoo-Jin Kim, Seok Lee, Chang-Ki Min, Seok-Goo Cho, Dong-Wook Kim, Jong-Wook Lee, Woo-Sung Min, Chong-Won Park Biology of Blood and Marrow Transplantation Volume 20, Issue 1, Pages 80-88 (January 2014) DOI: 10.1016/j.bbmt.2013.10.015 Copyright © 2014 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 1 OS and DFS of adverse-risk karyotype AML according to the number of chromosomal aberrations in all 211 patients (A) and in the patients who underwent allo-HSCT (B). In the 3 subgroups classified by NCA, the NCA≥5 subgroup demonstrated the worst outcomes even after treatment with allo-HSCT. In this study, the most prognostic predictive NCA could be determined at the level of 5 in adverse-risk karyotype AML. Biology of Blood and Marrow Transplantation 2014 20, 80-88DOI: (10.1016/j.bbmt.2013.10.015) Copyright © 2014 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 2 (A) NK mosaicism in combination with an adverse-risk karyotype was associated with significantly superior OS and DFS on multivariate analysis (with variables including age, sex, abnormal chromosomal aberrations, and initial treatment). (B) In the CK+MK+ subgroup, NK mosaicism was associated with significantly favorable OS and DFS compared with no NK mosaicism. Biology of Blood and Marrow Transplantation 2014 20, 80-88DOI: (10.1016/j.bbmt.2013.10.015) Copyright © 2014 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 3 (A) In analysis of the entire group (n = 211), subgroup 4 (NCA ≥5 without NK mosaicism; n = 31) showed the worst OS (HR, 3.2; 95% CI, 2.0-5.1; P < .001) and DFS (HR, 2.3; 95% CI, 1.4-3.6; P < .001), whereas subgroup 1 (NCA <5 with NK mosaicism; n = 77) showed significantly superior OS and DFS. (B) In analysis of the patients who underwent allo-HSCT, subgroup 4 (n = 6) had the worst OS (HR, 3.8; 95% CI, 1.6-8.9; P = .002) and highest CIR rate (HR, 6.3; 95% CI 1.9-20.3; P = .002) of all the subgroups. In contrast, subgroup 1 (n = 30) showed the most favorable OS with a lower CIR rate after allo-HSCT. Biology of Blood and Marrow Transplantation 2014 20, 80-88DOI: (10.1016/j.bbmt.2013.10.015) Copyright © 2014 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 4 OS and DFS curves according to postremission treatments. Biology of Blood and Marrow Transplantation 2014 20, 80-88DOI: (10.1016/j.bbmt.2013.10.015) Copyright © 2014 American Society for Blood and Marrow Transplantation Terms and Conditions