Impact of Cytogenetics Risk on Outcome After Reduced Intensity Conditioning (RIC) Allogeneic Stem Cell Transplantation (allo-SCT) From an HLA Identical Sibling for Patients With Acute Myeloid Leukemia (AML) in First Complete Remission (CR1)

Abstract

Allo-SCT is a well established therapy for adult patients with AML. In the setting of standard myeloablative allo-SCT, the fear of early death as a result of the procedure led to the restriction of allo-SCT in CR1 to patients who presented with high risk AML features, especially taking into account the impact of cytogenetics risk on outcome determining standard (good)-, intermediate-, and poor-risk populations. In the last decade, RIC allo-SCT has emerged as an attractive modality to decrease toxicity and widen the spectrum of AML patients who are candidate to allo-SCT. However, the issue of possible higher relapse rates after RIC allo-SCT, and continuous improvements in non-allo-SCT strategies, raise concern about the utility of this approach in AML patients in CR1 (e.g. in comparison to intensive chemotherapy and new drugs). Of note, no large studies have yet assessed the impact of cytogenetics risk on outcome in the context of RIC allo-SCT. This report describes the results of 378 AML patients (185 males) transplanted in CR1 using a RIC regimen and reported to the EBMT registry between 2000 and 2007, and for whom detailed cytogenetics data were available. All patients received RIC allo-SCT from an HLA identical sibling. RIC was defined as Busulfan conditioning regimens containing