Monosomal karyotype affecting outcomes of allogeneic hematopoietic stem cell transplantation for acute myeloid leukemia in first complete remission.

HEMATOPOIETIC stem cell transplantation; ACUTE myeloid leukemia; LEUKOCYTE count; AGE groups

Objectives: We evaluated the prognostic impact of MK on postremission outcomes of AML patients receiving allogeneic hematopoietic stem cell transplantation (HSCT) in the first complete remission (CR1). Methods: We retrospectively analyzed 465 adult patients with AML who had received HSCT in the first CR between 2000 and 2016. Results: In MK + AML, the median leukocyte count was significantly lower (P <.001) and no NPM1 mutation was found (P =.042). Multivariate analysis revealed that MK was the most powerful prognostic factors for OS (hazard ratio [HR], 2.6; P =.001), EFS (HR, 3.8; P <.001), and cumulative incidence of relapse (HR, 6.1; P <.001), compared to any other poor risk factors such as complex karyotype, FLT3‐ITD mutations, old age, and higher leukocyte count. The adverse prognostic impact of MK tended to be more prominent in the younger age group (<40 years) (HR, 6.3, P <.001) than in the older age group (≥40 years) (HR, 3.4, P <.001). Conclusion: Novel treatment modalities for MK + AML need to be investigated to reduce the risk of relapse after HSCT. [ABSTRACT FROM AUTHOR]

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