ABCG2, Cytogenetics, and Age Predict Relapse after Allogeneic Stem Cell Transplantation for Acute Myeloid Leukemia in Complete Remission

Autor: Daniela Damiani, Antonella Geromin, Angela Michelutti, Renato Fanin, Francesca Zanini, Mario Tiribelli, Michela Cerno
Rok vydání: 2016
Předmět:
Male
Oncology
medicine.medical_treatment
Hematopoietic stem cell transplantation
ABCG2
Acute myeloid leukemia
Relapse
Transplantation
Hematology
0302 clinical medicine
Recurrence
Risk Factors
hemic and lymphatic diseases
ATP Binding Cassette Transporter
Subfamily G
Member 2
Cumulative incidence
education.field_of_study
Incidence (epidemiology)
Remission Induction
Age Factors
Hematopoietic Stem Cell Transplantation
Myeloid leukemia
Middle Aged
Prognosis
Neoplasm Proteins
Leukemia
Myeloid
Acute
030220 oncology & carcinogenesis
Female
Adult
medicine.medical_specialty
Adolescent
Population
Cytogenetics
Young Adult
03 medical and health sciences
Internal medicine
medicine
Humans
Transplantation
Homologous
Risk factor
education
Survival analysis
Aged
Retrospective Studies
business.industry
Survival Analysis
Surgery
business
030215 immunology
Zdroj: Biology of Blood and Marrow Transplantation. 22:1621-1626
ISSN: 1083-8791
Popis: Recent studies have shown that ABGG2 protein overexpression in acute myeloid leukemia (AML) may be associated with poor response to therapy and increased relapse risk. Few data are available in patients with AML undergoing allogeneic stem cell transplantation (SCT), particularly when in complete remission (CR). We analyzed 105 patients with AML who underwent allogeneic SCT in CR evaluating the role of ABCG2 and other pretransplantation features on subsequent transplantation outcomes. Factors negatively associated with leukemia-free survival (LFS) were unfavorable cytogenetics (3-year LFS 48% versus 80%, P = .0035) and ABCG2 positivity (65% versus 80%, P = .045). Three-year cumulative incidence of relapse (CIR) in the whole population was 20%; a higher incidence of relapse was associated with adverse cytogenetics (41% versus 16%, P = .018), ABCG2 overexpression (29% versus 15%, P = .04), and, marginally, age > 50 years (30% versus 14%, P = .06). We grouped patients according to the combination of these 3 risk factors: no patient relapsed within 3 years from SCT in the group without risk factors, whereas the 3-year CIR was 12% (95% confidence interval [CI], 2% to 25%) in the group with 1 risk factor and 47% (95% CI, 31% to 70%) in patients with 2 or 3 risk factors (P = .00005). In conclusion, allogeneic SCT does not seem to abrogate the negative prognosis associated with ABCG2 overexpression at diagnosis, specifically in terms of a higher relapse risk. ABCG2, age, and cytogenetics can predict AML relapse after SCT in patients who undergo transplantation while in CR.
Databáze: OpenAIRE
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