|Title||Impact of Conditioning Intensity of Allogeneic Transplantation for Acute Myeloid Leukemia With Genomic Evidence of Residual Disease.|
|Publication Type||Journal Article|
|Year of Publication||2020|
|Authors||Hourigan, CS, Dillon, LW, Gui, G, Logan, BR, Fei, M, Ghannam, J, Li, Y, Licon, A, Alyea, EP, Bashey, A, H Deeg, J, Devine, SM, Fernandez, HF, Giralt, S, Hamadani, M, Howard, A, Maziarz, RT, Porter, DL, Scott, BL, Warlick, ED, Pasquini, MC, Horwitz, ME|
|Journal||J Clin Oncol|
|Date Published||2020 04 20|
|Keywords||Adult, Aged, Circulating Tumor DNA, Clinical Trials, Phase III as Topic, Female, Hematopoietic Stem Cell Transplantation, High-Throughput Nucleotide Sequencing, Humans, Leukemia, Myeloid, Acute, Male, Middle Aged, Mutation, Neoplasm, Residual, Prognosis, Randomized Controlled Trials as Topic, Transplantation Conditioning, Transplantation, Homologous, Young Adult|
PURPOSE: Patients with acute myeloid leukemia (AML) in remission remain at risk for relapse even after allogeneic hematopoietic cell transplantation (alloHCT). AML measurable residual disease (MRD) status before alloHCT has been shown to be prognostic. Whether modulation of the intensity of the alloHCT conditioning regimen in patients with AML who test positive for MRD can prevent relapse and improve survival is unknown.
METHODS: Ultra-deep, error-corrected sequencing for 13 commonly mutated genes in AML was performed on preconditioning blood from patients treated in a phase III clinical trial that randomly assigned adult patients with myeloid malignancy in morphologic complete remission to myeloablative conditioning (MAC) or reduced-intensity conditioning (RIC).
RESULTS: No mutations were detected in 32% of MAC and 37% of RIC recipients; these groups had similar survival (3-year overall survival [OS], 56% 63%; = .96). In patients with a detectable mutation (next-generation sequencing [NGS] positive), relapse (3-year cumulative incidence, 19% 67%;
CONCLUSION: This study provides evidence that MAC rather than RIC in patients with AML with genomic evidence of MRD before alloHCT can result in improved survival.
|Alternate Journal||J Clin Oncol|
|PubMed Central ID||PMC7164487|
|Grant List||U10 HL069274 / HL / NHLBI NIH HHS / United States |
P30 CA008748 / CA / NCI NIH HHS / United States
UG1 HL138658 / HL / NHLBI NIH HHS / United States
U10 HL069246 / HL / NHLBI NIH HHS / United States
U24 CA076518 / CA / NCI NIH HHS / United States
U24 HL138660 / HL / NHLBI NIH HHS / United States