Impact of pre-transplant induction and consolidation cycles on AML allogeneic transplant outcomes: a CIBMTR analysis in 3113 AML patients

Michael Boyiadzis; Mei Jie Zhang; Karen Chen; Hisham Abdel-Azim; Muhammad Bilal Abid; Mahmoud Aljurf; Ulrike Bacher; Talha Badar; Sherif M. Badawy; Minoo Battiwalla; Nelli Bejanyan; Vijaya Raj Bhatt; Valerie I. Brown; Paul Castillo; Jan Cerny; Edward A. Copelan; Charles Craddock; Bhagirathbhai Dholaria; Miguel Angel Diaz Perez; Christen L. Ebens; Robert Peter Gale; Siddhartha Ganguly; Lohith Gowda; Michael R. Grunwald; Shahrukh Hashmi; Gerhard C. Hildebrandt; Madiha Iqbal; Omer Jamy; Mohamed A. Kharfan-Dabaja; Nandita Khera; Hillard M. Lazarus; Richard Lin; Dipenkumar Modi; Sunita Nathan; Taiga Nishihori; Sagar S. Patel; Attaphol Pawarode; Wael Saber; Akshay Sharma; Melhem Solh; John L. Wagner; Trent Wang; Kirsten M. Williams; Lena E. Winestone; Baldeep Wirk; Amer Zeidan; Christopher S. Hourigan; Mark Litzow; Partow Kebriaei; Marcos de Lima; Kristin Page; Daniel J. Weisdorf

doi:10.1038/s41375-022-01738-3

Impact of pre-transplant induction and consolidation cycles on AML allogeneic transplant outcomes: a CIBMTR analysis in 3113 AML patients

Michael Boyiadzis, Mei Jie Zhang, Karen Chen, Hisham Abdel-Azim, Muhammad Bilal Abid, Mahmoud Aljurf, Ulrike Bacher, Talha Badar, Sherif M. Badawy, Minoo Battiwalla, Nelli Bejanyan, Vijaya Raj Bhatt, Valerie I. Brown, Paul Castillo, Jan Cerny, Edward A. Copelan, Charles Craddock, Bhagirathbhai Dholaria, Miguel Angel Diaz Perez, Christen L. EbensRobert Peter Gale, Siddhartha Ganguly, Lohith Gowda, Michael R. Grunwald, Shahrukh Hashmi, Gerhard C. Hildebrandt, Madiha Iqbal, Omer Jamy, Mohamed A. Kharfan-Dabaja, Nandita Khera, Hillard M. Lazarus, Richard Lin, Dipenkumar Modi, Sunita Nathan, Taiga Nishihori, Sagar S. Patel, Attaphol Pawarode, Wael Saber, Akshay Sharma, Melhem Solh, John L. Wagner, Trent Wang, Kirsten M. Williams, Lena E. Winestone, Baldeep Wirk, Amer Zeidan, Christopher S. Hourigan, Mark Litzow, Partow Kebriaei, Marcos de Lima, Kristin Page, Daniel J. Weisdorf

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Abstract

We investigated the impact of the number of induction/consolidation cycles on outcomes of 3113 adult AML patients who received allogeneic hematopoietic cell transplantation (allo-HCT) between 2008 and 2019. Patients received allo-HCT using myeloablative (MAC) or reduced-intensity (RIC) conditioning in first complete remission (CR) or with primary induction failure (PIF). Patients who received MAC allo-HCT in CR after 1 induction cycle had 1.3-fold better overall survival (OS) than 2 cycles to CR and 1.47-fold better than ≥3 cycles. OS after CR in 2 or ≥3 cycles was similar. Relapse risk was 1.65-fold greater in patients receiving ≥3 cycles to achieve CR. After RIC allo-HCT, the number of induction cycles to CR did not affect OS. Compared to CR in 1 cycle, relapse risk was 1.24-1.41-fold greater in patients receiving 2 or ≥3 cycles. For patients receiving only 1 cycle to CR, consolidation therapy prior to MAC allo-HCT was associated with improved OS vs. no consolidation therapy. Detectable MRD at the time of MAC allo-HCT did not impact outcomes while detectable MRD preceding RIC allo-HCT was associated with an increased risk of relapse. For allo-HCT in PIF, OS was significantly worse than allo-HCT in CR after 1–3 cycles.

Original language	English (US)
Pages (from-to)	1006-1017
Number of pages	12
Journal	Leukemia
Volume	37
Issue number	5
DOIs	https://doi.org/10.1038/s41375-022-01738-3
State	Published - May 2023

Bibliographical note

Funding Information:
The authors thank the patients and families for their courage and confidence in their medical teams; and the data management staff at the transplant Centers for their dedicated work in submitting data to the CIBMTR. This work was supported in part by the Intramural Research Program of the National Heart, Lung, and Blood Institute (CSH).

Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Nature Limited.

PubMed: MeSH publication types

Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.
Research Support, Non-U.S. Gov't

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1038/s41375-022-01738-3

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Boyiadzis, M., Zhang, M. J., Chen, K., Abdel-Azim, H., Abid, M. B., Aljurf, M., Bacher, U., Badar, T., Badawy, S. M., Battiwalla, M., Bejanyan, N., Bhatt, V. R., Brown, V. I., Castillo, P., Cerny, J., Copelan, E. A., Craddock, C., Dholaria, B., Perez, M. A. D., ... Weisdorf, D. J. (2023). Impact of pre-transplant induction and consolidation cycles on AML allogeneic transplant outcomes: a CIBMTR analysis in 3113 AML patients. Leukemia, 37(5), 1006-1017. https://doi.org/10.1038/s41375-022-01738-3

Boyiadzis, M, Zhang, MJ, Chen, K, Abdel-Azim, H, Abid, MB, Aljurf, M, Bacher, U, Badar, T, Badawy, SM, Battiwalla, M, Bejanyan, N, Bhatt, VR, Brown, VI, Castillo, P, Cerny, J, Copelan, EA, Craddock, C, Dholaria, B, Perez, MAD, Ebens, CL, Gale, RP, Ganguly, S, Gowda, L, Grunwald, MR, Hashmi, S, Hildebrandt, GC, Iqbal, M, Jamy, O, Kharfan-Dabaja, MA, Khera, N, Lazarus, HM, Lin, R, Modi, D, Nathan, S, Nishihori, T, Patel, SS, Pawarode, A, Saber, W, Sharma, A, Solh, M, Wagner, JL, Wang, T, Williams, KM, Winestone, LE, Wirk, B, Zeidan, A, Hourigan, CS, Litzow, M, Kebriaei, P, de Lima, M, Page, K & Weisdorf, DJ 2023, 'Impact of pre-transplant induction and consolidation cycles on AML allogeneic transplant outcomes: a CIBMTR analysis in 3113 AML patients', Leukemia, vol. 37, no. 5, pp. 1006-1017. https://doi.org/10.1038/s41375-022-01738-3

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title = "Impact of pre-transplant induction and consolidation cycles on AML allogeneic transplant outcomes: a CIBMTR analysis in 3113 AML patients",

abstract = "We investigated the impact of the number of induction/consolidation cycles on outcomes of 3113 adult AML patients who received allogeneic hematopoietic cell transplantation (allo-HCT) between 2008 and 2019. Patients received allo-HCT using myeloablative (MAC) or reduced-intensity (RIC) conditioning in first complete remission (CR) or with primary induction failure (PIF). Patients who received MAC allo-HCT in CR after 1 induction cycle had 1.3-fold better overall survival (OS) than 2 cycles to CR and 1.47-fold better than ≥3 cycles. OS after CR in 2 or ≥3 cycles was similar. Relapse risk was 1.65-fold greater in patients receiving ≥3 cycles to achieve CR. After RIC allo-HCT, the number of induction cycles to CR did not affect OS. Compared to CR in 1 cycle, relapse risk was 1.24-1.41-fold greater in patients receiving 2 or ≥3 cycles. For patients receiving only 1 cycle to CR, consolidation therapy prior to MAC allo-HCT was associated with improved OS vs. no consolidation therapy. Detectable MRD at the time of MAC allo-HCT did not impact outcomes while detectable MRD preceding RIC allo-HCT was associated with an increased risk of relapse. For allo-HCT in PIF, OS was significantly worse than allo-HCT in CR after 1–3 cycles.",

author = "Michael Boyiadzis and Zhang, {Mei Jie} and Karen Chen and Hisham Abdel-Azim and Abid, {Muhammad Bilal} and Mahmoud Aljurf and Ulrike Bacher and Talha Badar and Badawy, {Sherif M.} and Minoo Battiwalla and Nelli Bejanyan and Bhatt, {Vijaya Raj} and Brown, {Valerie I.} and Paul Castillo and Jan Cerny and Copelan, {Edward A.} and Charles Craddock and Bhagirathbhai Dholaria and Perez, {Miguel Angel Diaz} and Ebens, {Christen L.} and Gale, {Robert Peter} and Siddhartha Ganguly and Lohith Gowda and Grunwald, {Michael R.} and Shahrukh Hashmi and Hildebrandt, {Gerhard C.} and Madiha Iqbal and Omer Jamy and Kharfan-Dabaja, {Mohamed A.} and Nandita Khera and Lazarus, {Hillard M.} and Richard Lin and Dipenkumar Modi and Sunita Nathan and Taiga Nishihori and Patel, {Sagar S.} and Attaphol Pawarode and Wael Saber and Akshay Sharma and Melhem Solh and Wagner, {John L.} and Trent Wang and Williams, {Kirsten M.} and Winestone, {Lena E.} and Baldeep Wirk and Amer Zeidan and Hourigan, {Christopher S.} and Mark Litzow and Partow Kebriaei and {de Lima}, Marcos and Kristin Page and Weisdorf, {Daniel J.}",

note = "Funding Information: The authors thank the patients and families for their courage and confidence in their medical teams; and the data management staff at the transplant Centers for their dedicated work in submitting data to the CIBMTR. This work was supported in part by the Intramural Research Program of the National Heart, Lung, and Blood Institute (CSH). Publisher Copyright: {\textcopyright} 2022, The Author(s), under exclusive licence to Springer Nature Limited.",

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doi = "10.1038/s41375-022-01738-3",

language = "English (US)",

volume = "37",

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T2 - a CIBMTR analysis in 3113 AML patients

AU - Boyiadzis, Michael

AU - Zhang, Mei Jie

AU - Chen, Karen

AU - Abdel-Azim, Hisham

AU - Abid, Muhammad Bilal

AU - Aljurf, Mahmoud

AU - Bacher, Ulrike

AU - Badar, Talha

AU - Badawy, Sherif M.

AU - Battiwalla, Minoo

AU - Bejanyan, Nelli

AU - Bhatt, Vijaya Raj

AU - Brown, Valerie I.

AU - Castillo, Paul

AU - Cerny, Jan

AU - Copelan, Edward A.

AU - Craddock, Charles

AU - Dholaria, Bhagirathbhai

AU - Perez, Miguel Angel Diaz

AU - Ebens, Christen L.

AU - Gale, Robert Peter

AU - Ganguly, Siddhartha

AU - Gowda, Lohith

AU - Grunwald, Michael R.

AU - Hashmi, Shahrukh

AU - Hildebrandt, Gerhard C.

AU - Iqbal, Madiha

AU - Jamy, Omer

AU - Kharfan-Dabaja, Mohamed A.

AU - Khera, Nandita

AU - Lazarus, Hillard M.

AU - Lin, Richard

AU - Modi, Dipenkumar

AU - Nathan, Sunita

AU - Nishihori, Taiga

AU - Patel, Sagar S.

AU - Pawarode, Attaphol

AU - Saber, Wael

AU - Sharma, Akshay

AU - Solh, Melhem

AU - Wagner, John L.

AU - Wang, Trent

AU - Williams, Kirsten M.

AU - Winestone, Lena E.

AU - Wirk, Baldeep

AU - Zeidan, Amer

AU - Hourigan, Christopher S.

AU - Litzow, Mark

AU - Kebriaei, Partow

AU - de Lima, Marcos

AU - Page, Kristin

AU - Weisdorf, Daniel J.

N1 - Funding Information: The authors thank the patients and families for their courage and confidence in their medical teams; and the data management staff at the transplant Centers for their dedicated work in submitting data to the CIBMTR. This work was supported in part by the Intramural Research Program of the National Heart, Lung, and Blood Institute (CSH). Publisher Copyright: © 2022, The Author(s), under exclusive licence to Springer Nature Limited.

PY - 2023/5

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N2 - We investigated the impact of the number of induction/consolidation cycles on outcomes of 3113 adult AML patients who received allogeneic hematopoietic cell transplantation (allo-HCT) between 2008 and 2019. Patients received allo-HCT using myeloablative (MAC) or reduced-intensity (RIC) conditioning in first complete remission (CR) or with primary induction failure (PIF). Patients who received MAC allo-HCT in CR after 1 induction cycle had 1.3-fold better overall survival (OS) than 2 cycles to CR and 1.47-fold better than ≥3 cycles. OS after CR in 2 or ≥3 cycles was similar. Relapse risk was 1.65-fold greater in patients receiving ≥3 cycles to achieve CR. After RIC allo-HCT, the number of induction cycles to CR did not affect OS. Compared to CR in 1 cycle, relapse risk was 1.24-1.41-fold greater in patients receiving 2 or ≥3 cycles. For patients receiving only 1 cycle to CR, consolidation therapy prior to MAC allo-HCT was associated with improved OS vs. no consolidation therapy. Detectable MRD at the time of MAC allo-HCT did not impact outcomes while detectable MRD preceding RIC allo-HCT was associated with an increased risk of relapse. For allo-HCT in PIF, OS was significantly worse than allo-HCT in CR after 1–3 cycles.

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Impact of pre-transplant induction and consolidation cycles on AML allogeneic transplant outcomes: a CIBMTR analysis in 3113 AML patients

Abstract

Bibliographical note

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UN SDGs

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