ELN 2017 Genetic Risk Stratification Predicts Survival of Acute Myeloid Leukemia Patients Receiving Allogeneic Hematopoietic Stem Cell Transplantation

ABSTRACT BACKGROUND European LeukemiaNet (ELN) 2017 risk stratification by genetics is prognostic of outcomes in patients with acute myeloid leukemia (AML). However, the prognostic impact of the 2017 ELN genetic risk stratification after allogeneic hematopoietic cell transplantation (alloHCT) is not well established. OBJECTIVE We examined the effect of 2017 ELN genetic risk stratification on alloHCT outcomes of AML. METHODS We included 500 adult (≥18 years) AML patients in first (n=370) or second (n=130) complete remission receiving alloHCT from 2005 to 2016. Patients were classified into favorable (12%), intermediate (57%), and adverse (32%) 2017 ELN risk groups. The Cox proportional hazard model was used to conduct the multivariable analyses of leukemia-free survival (LFS) and overall survival (OS). Relapse and non-relapse mortality were analyzed by the Fine-Gray regression model. RESULTS OS at 2 years was 72% in the favorable vs. 60% in the intermediate vs. 45% in the adverse risk groups (p CONCLUSION These data highlight the prognostic impact of the 2017 ELN genetic risk stratification on the survival of AML patients following alloHCT. Patients in the adverse risk group had the highest risk of relapse and worst survival. Thus, the 2017 ELN prognostic system can help identify AML patients who may benefit from clinical trials offering relapse mitigation strategies in order to improve transplant outcomes.