Allogeneic Stem-Cell Transplantation in Patients With NPM1-Mutated Acute Myeloid Leukemia: Results From a Prospective Donor Versus No-Donor Analysis of Patients After Upfront HLA Typing Within the SAL-AML 2003 Trial

Roellig C, Bornhaeuser M, Kramer M, Thiede C, Ho AD, Kraemer A, Schaefer-Eckart K, Wandt H, Haenel M, Einsele H, Aulitzky WE, Schmitz N, Berdel WE, Stelljes M, Mueller-Tidow C, Krug U, Platzbecker U, Wermke M, Baldus CD, Krause S, Stoelzel F, Von Bonin M, Schaich M, Serve H, Schetelig J, Ehninger G (2015)

Publication Type: Journal article

Publication year: 2015

Journal

Journal of Clinical Oncology American Society of Clinical Oncology

Book Volume: 33

Pages Range: 403-10

Journal Issue: 5

DOI: 10.1200/JCO.2013.54.4973

Abstract

The presence of a mutated nucleophosmin-1 gene (NPM1mut) in acute myeloid leukemia (AML) is associated with a favorable prognosis. To assess the predictive value with regard to allogeneic stem-cell transplantation (SCT), we compared the clinical course of patients with NPM1mut AML eligible for allogeneic SCT in a donor versus no-donor analysis.Of 1,179 patients with AML (age 18 to 60 years) treated in the Study Alliance Leukemia AML 2003 trial, we identified all NPM1mut patients with an intermediate-risk karyotype. According to the trial protocol, patients were intended to receive an allogeneic SCT if an HLA-identical sibling donor was available. Patients with no available donor received consolidation or autologous SCT. We compared relapse-free survival (RFS) and overall survival (OS) depending on the availability of a suitable donor.Of 304 eligible patients, 77 patients had a sibling donor and 227 had no available matched family donor. The 3-year RFS rates in the donor and no-donor groups were 71% and 47%, respectively (P = .005); OS rates were 70% and 60%, respectively (P = .114). In patients with normal karyotype and no FLT3 internal tandem duplication (n = 148), the 3-year RFS rates in the donor and no-donor groups were 83% and 53%, respectively (P = .004); and the 3-year OS rates were 81% and 75%, respectively (P = .300).Allogeneic SCT led to a significantly prolonged RFS in patients with NPM1mut AML. The absence of a statistically significant difference in OS is most likely a result of the fact that NPM1mut patients who experienced relapse responded well to salvage treatment. Allogeneic SCT in first remission has potent antileukemic efficacy and is a valuable treatment option in patients with NPM1mut AML with a sibling donor.

Authors with CRIS profile

Stefan Krause Department of Medicine 5 – Haematology and Oncology

Involved external institutions

Asklepios Kliniken DE Germany (DE) Universitätsklinikum Frankfurt am Main (KGU) DE Germany (DE) Technische Universität Dresden DE Germany (DE) Charité - Universitätsmedizin Berlin DE Germany (DE) Universitätsklinikum Münster DE Germany (DE) Universitätsklinikum Halle (Saale) DE Germany (DE) Robert-Bosch-Krankenhaus DE Germany (DE) Universitätsklinikum Würzburg DE Germany (DE) Klinikum Chemnitz DE Germany (DE) Klinikum Nürnberg DE Germany (DE) Universitätsklinikum Heidelberg DE Germany (DE)

How to cite

APA:

Roellig, C., Bornhaeuser, M., Kramer, M., Thiede, C., Ho, A.D., Kraemer, A.,... Ehninger, G. (2015). Allogeneic Stem-Cell Transplantation in Patients With NPM1-Mutated Acute Myeloid Leukemia: Results From a Prospective Donor Versus No-Donor Analysis of Patients After Upfront HLA Typing Within the SAL-AML 2003 Trial. Journal of Clinical Oncology, 33(5), 403-10. https://doi.org/10.1200/JCO.2013.54.4973

MLA:

Roellig, Christoph, et al. "Allogeneic Stem-Cell Transplantation in Patients With NPM1-Mutated Acute Myeloid Leukemia: Results From a Prospective Donor Versus No-Donor Analysis of Patients After Upfront HLA Typing Within the SAL-AML 2003 Trial." Journal of Clinical Oncology 33.5 (2015): 403-10.

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