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The EBMT Cytogenetic Risk Score maintains its prognostic significance in acute myeloid leukemia following allogeneic stem cell transplantation in a cohort with 40% of patients transplanted with in vitro partial T-cell depleted graft

Bone Marrow Transplantation volume 56, pages 2284–2286 (2021)Cite this article

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Cytogenetic [1] and molecular pattern [2] of acute myeloid leukemia (AML) is prognostic for survival and relapse incidence and also for patient undergoing allogeneic hematopoietic stem cell transplantation (alloHSCT) for consolidation. Different validated prognostic scores, such as the disease risk index [3, 4], have demonstrated the impact of cytogenetic pattern of AML in this context. Recently, a new prognostic score, the AML EBMT Cytogenetic Risk score (EBMT-CRS) [5, 6] was published, combining cytogenetics and FLT3-ITD status for AML patients in complete remission (CR) at transplant time. The EBMT-CRS is prognostic for leukemia-free survival (LFS), overall survival (OS), GVHD-free/relapse-free survival (GRFS) and cumulative incidence of relapse (CIR). This model was initially investigated in first CR (CR1) for AML patients undergoing alloHSCT with matched donor (MD) (fully-matched related and unrelated donor) without ex-vivo manipulation grafts and was also validated for patients with positive minimal measurable disease (MRD+). In our transplant center (Geneva University Hospitals), we frequently offer in-vitro partial T-cell depleted graft (pTDEP) for patient in CR [7]. Graft is initially T-cell depleted with alemtuzumab (Sanofi, France), infused at Day 0, followed with an addback of T cells (100 × 106 cells) on day +1 to decrease morbidity and mortality associated with graft-versus-host disease (GvHD). We previously demonstrated that pTDEP significantly improves GRFS and GVHD without harming OS, DFS, or RI in selected patients [8, 9]. Currently, The EBMT-CRS has not been evaluated in pTDEP patients.

In this retrospective monocentric study, we investigated the impact of the EBMT-CRS for 2 years LFS, OS, GRFS, CIR, NRM, acute and chronic GVHD in a cohort with patients allografted with pTDEP graft. All consecutive ≥18 years patients in CR at transplant time who received a first allograft for AML between 2008 and 2018 with data available to determine the EBMT-CRS were included. OS, LFS, GRFS were investigated with the Kaplan–Meier method. CIR (with NRM as competing event), NRM (with relapse as competing event) and acute and chronic GvHD (with relapse as competing event) were investigated with the cumulative incidence estimator as defined by Fine and Gray. All patients provided written consent authorizing the use of their data for research publication. This study was conducted in accordance with the Declaration of Helsinki and Good Clinical Practices guidelines.

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Authors and Affiliations

  1. Haematology Division, Department of Oncology, Geneva University Hospitals, Geneva, Switzerland

    Yan Beauverd, Sarah Morin, Caroline Stephan, Carmen De Ramon Ortiz, Marta Fabra Urdiola, Federica Giannotti, Elif Mahne, Anne-Claire Mamez, Maria Mappoura, Federico Simonetta, Thien-An Tran, Christian Ayer, Sarah Noetzlin, Isaline Verdon, Stavroula Masouridi-Levrat & Yves Chalandon

  2. Faculty of Medicine, University of Geneva, Geneva, Switzerland

    Federico Simonetta & Yves Chalandon

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  1. Yan Beauverd
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  2. Sarah Morin
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  3. Caroline Stephan
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Correspondence to Yves Chalandon.

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Beauverd, Y., Morin, S., Stephan, C. et al. The EBMT Cytogenetic Risk Score maintains its prognostic significance in acute myeloid leukemia following allogeneic stem cell transplantation in a cohort with 40% of patients transplanted with in vitro partial T-cell depleted graft. Bone Marrow Transplant 56, 2284–2286 (2021). https://doi.org/10.1038/s41409-021-01334-6

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