AUTHOR=Zhou Wei , Chen Guofeng , Gong Dan , Gao Yi , Yu Li 

TITLE=Risk factors for post-transplant relapse and survival in younger adult patients with t(8;21)(q22;q22) acute myeloid leukemia undergoing allogeneic hematopoietic stem cell transplantation: A multicenter retrospective study

JOURNAL=Frontiers in Oncology

VOLUME=13

YEAR=2023

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2023.1138853

DOI=10.3389/fonc.2023.1138853

ISSN=2234-943X

ABSTRACT=<sec><title>Background</title><p>Outcomes of patients with t(8;21)(q22;q22) acute myeloid leukemia (AML) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) remain heterogeneous.</p></sec><sec><title>Methods</title><p>To identify the risk factors for relapse and survival after allo-HSCT in t(8;21) AML patients, we retrospectively evaluated the clinical and prognostic information of 142 patients with t(8;21) AML undergoing allo-HSCT between January 2002 and September 2018 at 15 hematology research centers in China.</p></sec><sec><title>Results</title><p>Twenty-nine patients (20%) relapsed after undergoing allo-HSCT. A &gt; 1-log reduction in <italic>RUNX1/RUNX1T1</italic>-based minimal residual disease (MRD) directly before allo-HSCT and a &gt; 3-log reduction within the first 3 months after allo-HSCT were associated with a significantly lower post-transplant 3-year cumulative incidence of relapse (CIR, 9% vs. 62% and 10% vs. 47%,all <italic>P</italic> &lt; 0.001), whereas transplantation during the second complete remission (CR2, 39% vs. 17% during CR1, <italic>P</italic> = 0.022), during relapse (62% vs. 17% during CR1, <italic>P</italic> &lt; 0.001) and <italic>KIT D816</italic> mutations at diagnosis (49% vs. 18%, <italic>P</italic> = 0.039) were related to a significantly higher 3-year CIR. Multivariate analysis demonstrated that a &gt; 1-log reduction in MRD directly before transplantation (CIR: hazard ratio(HR), 0.21 [0.03–0.71], <italic>P</italic> = 0.029; overall survival (OS): HR = 0.27 [0.08–0.93], <italic>P</italic> = 0.038) and a &gt; 3-log reduction in post-transplant MRD within the first 3 months (CIR: HR = 0.25 [0.07–0.89], <italic>P</italic> = 0.019; OS: HR = 0.38 [0.15–0.96], <italic>P</italic> = 0.040) were independent favorable prognostic factors, and transplantation during relapse (CIR: HR = 5.55 [1.23–11.56], <italic>P</italic> = 0.041; OS: HR = 4.07 [1.82–20.12], <italic>P</italic> = 0.045) were independent adverse prognostic factors for post-transplant relapse and survival in patients with t(8;21) AML.</p></sec><sec><title>Conclusion</title><p>Our study suggests that for patients with t(8;21) AML undergoing allo-HSCT, it would be better to receive transplantation during CR1 with a MRD directly before transplantation achieving at least 1-log reduction. MRD monitoring in the first 3 months after allo-HSCT might be robust in predicting relapse and adverse survival after allo-HSCT.</p></sec>