Challenging the Adverse Label: Diverse Outcomes of <scp>ELN</scp> 2022 Adverse Cytogenetic Subgroups in Acute Myeloid Leukemia Patients Allografted in First Remission: From <scp>EBMT ALWP</scp>

According to the European LeukemiaNet (ELN) 2022 classification, acute myeloid leukemia (AML) patients with intermediate or adverse risk are offered allogeneic hematopoietic stem cell transplantation (allo-HSCT) in first remission. In this EBMT study, we included 1735 adult AML patients with ELN-2022 adverse-risk cytogenetics allografted between 2010 and 2022 in first remission (67% de novo AML, median age 56 years). Eleven non-overlapping adverse-risk cytogenetics groups were defined. The five most frequent were: Group 1 [n = 394; monosomy 17 or abn(17p); 2-year leukemia-free survival (LFS) 22%, and overall survival (OS) 25%]; Group 2 [n = 313; complex karyotype (CK) involving monosomy 5, monosomy 7, or del(5q) without monosomy 17 or abn(17p); LFS 27%, OS 37%]; Group 3 [n = 201; monosomy 5, monosomy 7, or del(5q) without CK and without monosomy 17 or abn(17p); LFS: 55%, OS: 63%]; Group 4 [n = 256; CK without monosomal karyotype (MK) or adverse additional cytogenetic abnormalities (ACA); LFS 50%, OS 61%]; Group 5 [n = 213; t(v, 11q23) without adverse ACA; LFS 50%, OS 59%]. In multivariable analysis, compared to CK without adverse ACA, LFS was negatively affected by monosomy 17 or 17p abnormalities, monosomy 5, 7, or del(5q) in the presence of CK, and t(8;16). In conclusion, this study revealed a very poor outcome of allografted AML patients with monosomy 17 or 17p abnormalities or CK involving monosomy 5, monosomy 7, and del5q. Outcomes were relatively favorable for most other ELN 2022 adverse categories, including CK with or without MK other than 5, 7, and 17, indicating that allo-HSCT can overcome their poor outcome.

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Publication Details

Journal
American Journal of Hematology
Published
2025-05-30
DOI
https://doi.org/10.1002/ajh.27726
Citations
3
Primary Topic
Acute Myeloid Leukemia Research
Type
article
Field-Weighted Citation Impact
5.31
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article

Challenging the Adverse Label: Diverse Outcomes of ELN 2022 Adverse Cytogenetic Subgroups in Acute Myeloid Leukemia Patients Allografted in First Remission: From EBMT ALWP

Éolia Brissot, Frédéric Baron, Jordi Esteve, Matthias Eder et al.
3 citations
American Journal of Hematology
Acute Myeloid Leukemia Research
5.31
article

Challenging the Adverse Label: Diverse Outcomes of ELN 2022 Adverse Cytogenetic Subgroups in Acute Myeloid Leukemia Patients Allografted in First Remission: From EBMT ALWP

Éolia Brissot, Frédéric Baron, Jordi Esteve, Matthias Eder, Ali Bazarbachi, Jurjen Versluis, Fabio Ciceri, Cristina Castilla‐Llorente, Ibrahim Yakoub‐Agha, Iman Abou Dalle, Tobias Gedde‐Dahl, Jacques‐Emmanuel Galimard, Johan A. Maertens, Mohamad Mohty, Gérard Socié, Edouard Forcade, Arnon Nagler, Goda Choi, Depei Wu, Hélène Labussière‐Wallet
article en
3 citations

Abstract

According to the European LeukemiaNet (ELN) 2022 classification, acute myeloid leukemia (AML) patients with intermediate or adverse risk are offered allogeneic hematopoietic stem cell transplantation (allo-HSCT) in first remission. In this EBMT study, we included 1735 adult AML patients with ELN-2022 adverse-risk cytogenetics allografted between 2010 and 2022 in first remission (67% de novo AML, median age 56 years). Eleven non-overlapping adverse-risk cytogenetics groups were defined. The five most frequent were: Group 1 [n = 394; monosomy 17 or abn(17p); 2-year leukemia-free survival (LFS) 22%, and overall survival (OS) 25%]; Group 2 [n = 313; complex karyotype (CK) involving monosomy 5, monosomy 7, or del(5q) without monosomy 17 or abn(17p); LFS 27%, OS 37%]; Group 3 [n = 201; monosomy 5, monosomy 7, or del(5q) without CK and without monosomy 17 or abn(17p); LFS: 55%, OS: 63%]; Group 4 [n = 256; CK without monosomal karyotype (MK) or adverse additional cytogenetic abnormalities (ACA); LFS 50%, OS 61%]; Group 5 [n = 213; t(v, 11q23) without adverse ACA; LFS 50%, OS 59%]. In multivariable analysis, compared to CK without adverse ACA, LFS was negatively affected by monosomy 17 or 17p abnormalities, monosomy 5, 7, or del(5q) in the presence of CK, and t(8;16). In conclusion, this study revealed a very poor outcome of allografted AML patients with monosomy 17 or 17p abnormalities or CK involving monosomy 5, monosomy 7, and del5q. Outcomes were relatively favorable for most other ELN 2022 adverse categories, including CK with or without MK other than 5, 7, and 17, indicating that allo-HSCT can overcome their poor outcome.

American Journal of HematologyVol. 100(8)
Oslo University Hospital (NO), University Medical Center Groningen (NL), Vita-Salute San Raffaele University (IT), Inserm (FR), University of Liège (BE), University of Groningen (NL), Sheba Medical Center (IL), Universitair Ziekenhuis Leuven (BE), Institut Gustave Roussy (FR), Centre Hospitalier Universitaire de Lille (FR), Medizinische Hochschule Hannover (DE), Soochow University (CN), Sorbonne Université (FR), Assistance Publique – Hôpitaux de Paris (FR), Hospices Civils de Lyon (FR), Hôpital Saint-Antoine (FR), Hôpital Cardiologique du Haut-Lévêque (FR), IRCCS Ospedale San Raffaele (IT), Centre de Recherche Saint-Antoine (FR), Biomedical Research Institute (US), Hôpital Saint-Louis (FR), Erasmus MC Cancer Institute (NL), First Affiliated Hospital of Soochow University (CN), Consorci Institut D'Investigacions Biomediques August Pi I Sunyer (ES), American University of Beirut (LB)
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Openalex Percentile: Top 5%
Acute Myeloid Leukemia Research
5.31
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