Factors Predicting Survival Following Allogeneic Stem Cell Transplant in Patients with Therapy-Related Myeloid Neoplasms

Baranwal, Anmol; Chhetri, Rakchha; Kok, Chung Hoow; Alkhateeb, Hassan B.; Mangaonkar, Abhishek A.; Johnson, Brynte H.; Clark, Matthew H.; Cibich, Alia; Bardy, Peter; Litzow, Mark R.; Hiwase, Devendra; Shah, Mithun Vinod

doi:10.1016/s2666-6367(22)00327-x

Cited by 4 publications

(6 citation statements)

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“…More recently, Baranwal et al had identified a very high-risk score (TP53/BCOR/IDH1/ GATA2/BCORL1) for Allo-HCT outcome with survival of 0% versus 64.6% (p = 0.001). 56 Our results do not suggest t-AML as an independent poor prognostic factor, because of the similarity of OS between t-AML and de novo AML. This is related to a matching of IC-treated patients on age, cytogenetics, and ELN2010 in the pair-matched analysis of t-AML and de novo AML.…”

Section: Discussioncontrasting

confidence: 70%

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Clinical outcome of therapy‐related acute myeloid leukemia patients. Real‐life experience in a University Hospital and a Cancer Center in France

Belhabri,

Heiblig,

Morisset

et al. 2023

Cancer Medicine

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Backgroundt‐AML occurs after a primary malignancy treatment and retains a poor prognosis.AimsTo determine the impact of primary malignancies, therapeutic strategies, and prognostic factors on clinical outcomes of t‐AML.ResultsA total of 112 adult patients were included in this study. Fifty‐Five patients received intensive chemotherapy (IC), 33 non‐IC, and 24 best supportive care. At t‐AML diagnosis, 42% and 44% of patients presented an unfavorable karyotype and unfavorable 2010 ELN risk profile, respectively. Among treated patients (n = 88), 43 (49%) achieved complete remission: four out of 33 (12%) and 39 out of 55 (71%) in non‐IC and IC groups, respectively. With a median follow‐up of 5.5 months, the median overall survival (OS) and disease‐free survival (DFS) for the whole population were 9 months and 6.3 months, respectively, and for the 88 treated patients 13.5 months and 8.2 months, respectively. Univariate analysis on OS and DFS showed a significant impact of high white blood cells (WBC) and blast counts at diagnosis, unfavorable karyotype and ELN classification. Multivariate analysis showed a negative impact of WBC count at diagnosis and a positive impact of chemotherapy on OS and DFS in the whole population. It also showed a negative impact of previous auto‐HCT and high WBC count on OS and DFS and of IC on OS in treated patients which disappeared when we considered only confounding variables (age, previous cancers, marrow blasts, and 2010 ELN classification). In a pair‐matched analysis comparing IC treated t‐AML with de novo AML, there was no difference of OS and DFS between the two populations.ConclusionWe showed, in this study that t‐AML patients with unfavorable features represented almost half of the population. Best outcomes obtained in patients receiving IC must be balanced by known confounding variables and should be improved by using new innovative agents and therapeutic strategies.

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Section: Discussioncontrasting

confidence: 70%

“…More recently, Baranwal et al had identified a very high‐risk score (TP53/BCOR/IDH1/ GATA2/BCORL1) for Allo‐HCT outcome with survival of 0% versus 64.6% ( p = 0.001) 56 …”

Section: Discussionmentioning

confidence: 99%

Clinical outcome of therapy‐related acute myeloid leukemia patients. Real‐life experience in a University Hospital and a Cancer Center in France

Belhabri,

Heiblig,

Morisset

et al. 2023

Cancer Medicine

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“…HMAs-long considered to be a cornerstone for treatment of high-risk MDS and unfit AML patients-do not substantially improve outcomes in t-MN. 10,11,12 Similarly, while SCT remains the "gold standard" modality, <20% patients are able to undergo SCT and outcomes following SCT remain sobering. [12][13][14] As opposed to relatively homogenous entity of AML, t-MN is a clinicopathological entity encompassing t-MDS, t-MDS/MPN, and t-AML.…”

Section: Discussionmentioning

confidence: 99%

“…10,11,12 Similarly, while SCT remains the "gold standard" modality, <20% patients are able to undergo SCT and outcomes following SCT remain sobering. [12][13][14] As opposed to relatively homogenous entity of AML, t-MN is a clinicopathological entity encompassing t-MDS, t-MDS/MPN, and t-AML. Therefore, there is an urgent need to assess the role of novel agents.…”

Section: Discussionmentioning

confidence: 99%

“…Despite improved understanding of the biology and pathogenesis, the current treatment landscape of t‐MN remains highly unsatisfactory. HMAs—long considered to be a cornerstone for treatment of high‐risk MDS and unfit AML patients—do not substantially improve outcomes in t‐MN 10,11,12 . Similarly, while SCT remains the “gold standard” modality, <20% patients are able to undergo SCT and outcomes following SCT remain sobering 12–14 .…”

Section: Discussionmentioning

confidence: 99%

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Outcomes following venetoclax‐based treatment in therapy‐related myeloid neoplasms

et al. 2022

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Therapy-related myeloid neoplasms (t-MN) are aggressive malignancies in need of effective therapies. The BCL-2 inhibitor venetoclax represents a paradigm shift in the treatment of acute myeloid leukemia. However, the effectiveness of venetoclax has not been studied in a large cohort of t-MN. We retrospectively analyzed 378 t-MN patients, of which 96 (25.4%, 47 therapy-related acute myeloid leukemia, 1 therapy-related chronic myelomonocytic leukemia, 48 therapy-related myelodysplastic syndrome) received venetoclax. Median interval from t-MN to venetoclax initiation was 2.9 (Interquartile range [IQR] 0.7-12) months, and patients received a median of 3 (IQR 1-4) cycles. The composite complete remission (CRc) rate, median progression-free survival (PFS), and overall survival (OS) were 39.1%, 4.9 months, and 7 months, respectively.The upfront use of venetoclax and achieving CRc were associated with improved survival, whereas the presence of Chromosome 7 abnormalities was associated with an inferior survival. Neither the TP53-status nor the percent bone marrow blast predicted the likelihood of CRc or survival. Paired genetic analysis performed at venetoclax initiation and failure did not show the evidence of the selection of the TP53-mutated clone.

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Role of Germline Predisposition to Therapy-Related Myeloid Neoplasms

Baranwal

Hahn

Shah

et al. 2022

Curr Hematol Malig Rep

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Factors Predicting Survival Following Allogeneic Stem Cell Transplant in Patients with Therapy-Related Myeloid Neoplasms

Cited by 4 publications

References 0 publications

Clinical outcome of therapy‐related acute myeloid leukemia patients. Real‐life experience in a University Hospital and a Cancer Center in France

Clinical outcome of therapy‐related acute myeloid leukemia patients. Real‐life experience in a University Hospital and a Cancer Center in France

Outcomes following venetoclax‐based treatment in therapy‐related myeloid neoplasms

Role of Germline Predisposition to Therapy-Related Myeloid Neoplasms

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