Distinct factors determine the kinetics of disease relapse in adults transplanted for acute myeloid leukaemia.
Craddock C., Versluis J., Labopin M., Socie G., Huynh A., Deconinck E., Volin L., Milpied N., Bourhis JH., Rambaldi A., Chevallier P., Blaise D., Manz M., Vellenga E., Vekemans M-C., Maertens J., Passweg J., Vyas P., Schmid C., Löwenberg B., Ossenkoppele G., Mohty M., Cornelissen JJ., Nagler A., Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation and HOVON-SAKK None.
BACKGROUND: Disease recurrence remains the major cause of death in adults with acute myeloid leukaemia (AML) treated using either intensive chemotherapy (IC) or allogenic stem cell transplantation (allo-SCT). AIMS: The timely delivery of maintenance drug or cellular therapies represent emerging strategies with the potential to reduce relapse after both treatment modalities, but whilst the determinants of overall relapse risk have been extensively characterized the factors determining the timing of disease recurrence have not been characterized. MATERIALS AND METHODS: We have therefore examined, using a series of sequential landmark analyses, relapse kinetics in a cohort of 2028 patients who received an allo-SCT for AML in CR1 and separately 570 patients treated with IC alone. RESULTS: In the first 3 months after allo-SCT, the factors associated with an increased risk of relapse included the presence of the FLT3-ITD (P