Late effects after ablative allogeneic stem cell transplantation for adolescent and young adult acute myeloid leukemia

Catherine J. Lee; Soyoung Kim; Heather R. Tecca; Stephanie Bo-Subait; Rachel Phelan; Ruta Brazauskas; David Buchbinder; Betty K. Hamilton; Minoo Battiwalla; Navneet S. Majhail; Hillard M. Lazarus; Peter J. Shaw; David I. Marks; Mark R. Litzow; Saurabh Chhabra; Yoshihiro Inamoto; Zachariah DeFilipp; Gerhard C. Hildebrandt; Richard F. Olsson; Kimberly A. Kasow; Jane L. Liesveld; Seth J. Rotz; Sherif M. Badawy; Neel S. Bhatt; Jean A. Yared; Kristin M. Page; Martha L. Arellano; Michael Kent; Nosha Farhadfar; Sachiko Seo; Peiman Hematti; Cesar O. Freytes; Alicia Rovo; Siddhartha Ganguly; Sunita Nathan; Linda Burns; Bronwen E. Shaw; Lori S. Muffly

doi:10.1182/bloodadvances.2019001126

Late effects after ablative allogeneic stem cell transplantation for adolescent and young adult acute myeloid leukemia

Catherine J. Lee, Soyoung Kim, Heather R. Tecca, Stephanie Bo-Subait, Rachel Phelan, Ruta Brazauskas, David Buchbinder, Betty K. Hamilton, Minoo Battiwalla, Navneet S. Majhail, Hillard M. Lazarus, Peter J. Shaw, David I. Marks, Mark R. Litzow, Saurabh Chhabra, Yoshihiro Inamoto, Zachariah DeFilipp, Gerhard C. Hildebrandt, Richard F. Olsson, Kimberly A. KasowJane L. Liesveld, Seth J. Rotz, Sherif M. Badawy, Neel S. Bhatt, Jean A. Yared, Kristin M. Page, Martha L. Arellano, Michael Kent, Nosha Farhadfar, Sachiko Seo, Peiman Hematti, Cesar O. Freytes, Alicia Rovo, Siddhartha Ganguly, Sunita Nathan, Linda Burns, Bronwen E. Shaw, Lori S. Muffly

Houston Methodist

Research output: Contribution to journal › Article › peer-review

36 Scopus citations

Abstract

There ismarkedpaucityofdata regarding late effects inadolescentsandyoungadults (AYAs)who undergo myeloablative conditioning (MAC) allogeneic hematopoietic cell transplantation (HCT) for acute myeloid leukemia (AML).We evaluated late effects and survival in 826 1-year diseasefree survivors of MAC HCT for AYA AML, with an additional focus on comparing late effects based upon MAC type (total body irradiation [TBI] vs high-dose chemotherapy only). The estimated 10-year cumulative incidence of subsequent neoplasms was 4% (95% confidence interval [CI], 2%-6%); 10-year cumulative incidence of nonmalignant late effects included gonadal dysfunction (10%; 95% CI, 8%-13%), cataracts (10%; 95% CI, 7%-13%), avascular necrosis (8%; 95% CI, 5%-10%), diabetes mellitus (5%; 95% CI, 3%-7%), and hypothyroidism (3%; 95% CI, 2%-5%). Receipt of TBIwas independently associatedwith a higher risk of cataracts only (hazard ratio [HR], 4.98; P <.0001) whereas chronic graft-versus-host disease (cGVHD) was associated with an increased risk of cataracts (HR, 3.22; P 5 =0006), avascular necrosis (HR, 2.49; P 5 .006), and diabetes mellitus (HR, 3.36; P 5 =03). Estimated 10-year overall survival and leukemia-free survival were 73% and 70%, respectively, and did not differ on the basis of conditioning type. In conclusion, late effects among survivors of MAC HCT for AYA AML are frequent and are more closely linked to cGVHD than type of conditioning.

Original language	English (US)
Pages (from-to)	983-992
Number of pages	10
Journal	Blood Advances
Volume	4
Issue number	6
DOIs	https://doi.org/10.1182/bloodadvances.2019001126
State	Published - Mar 24 2020

ASJC Scopus subject areas

Hematology

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10.1182/bloodadvances.2019001126

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Lee, C. J., Kim, S., Tecca, H. R., Bo-Subait, S., Phelan, R., Brazauskas, R., Buchbinder, D., Hamilton, B. K., Battiwalla, M., Majhail, N. S., Lazarus, H. M., Shaw, P. J., Marks, D. I., Litzow, M. R., Chhabra, S., Inamoto, Y., DeFilipp, Z., Hildebrandt, G. C., Olsson, R. F., ... Muffly, L. S. (2020). Late effects after ablative allogeneic stem cell transplantation for adolescent and young adult acute myeloid leukemia. Blood Advances, 4(6), 983-992. https://doi.org/10.1182/bloodadvances.2019001126

Lee, CJ, Kim, S, Tecca, HR, Bo-Subait, S, Phelan, R, Brazauskas, R, Buchbinder, D, Hamilton, BK, Battiwalla, M, Majhail, NS, Lazarus, HM, Shaw, PJ, Marks, DI, Litzow, MR, Chhabra, S, Inamoto, Y, DeFilipp, Z, Hildebrandt, GC, Olsson, RF, Kasow, KA, Liesveld, JL, Rotz, SJ, Badawy, SM, Bhatt, NS, Yared, JA, Page, KM, Arellano, ML, Kent, M, Farhadfar, N, Seo, S, Hematti, P, Freytes, CO, Rovo, A, Ganguly, S, Nathan, S, Burns, L, Shaw, BE & Muffly, LS 2020, 'Late effects after ablative allogeneic stem cell transplantation for adolescent and young adult acute myeloid leukemia', Blood Advances, vol. 4, no. 6, pp. 983-992. https://doi.org/10.1182/bloodadvances.2019001126

@article{d6a7a4a330d5499d810eaf478532380c,

title = "Late effects after ablative allogeneic stem cell transplantation for adolescent and young adult acute myeloid leukemia",

abstract = "There ismarkedpaucityofdata regarding late effects inadolescentsandyoungadults (AYAs)who undergo myeloablative conditioning (MAC) allogeneic hematopoietic cell transplantation (HCT) for acute myeloid leukemia (AML).We evaluated late effects and survival in 826 1-year diseasefree survivors of MAC HCT for AYA AML, with an additional focus on comparing late effects based upon MAC type (total body irradiation [TBI] vs high-dose chemotherapy only). The estimated 10-year cumulative incidence of subsequent neoplasms was 4% (95% confidence interval [CI], 2%-6%); 10-year cumulative incidence of nonmalignant late effects included gonadal dysfunction (10%; 95% CI, 8%-13%), cataracts (10%; 95% CI, 7%-13%), avascular necrosis (8%; 95% CI, 5%-10%), diabetes mellitus (5%; 95% CI, 3%-7%), and hypothyroidism (3%; 95% CI, 2%-5%). Receipt of TBIwas independently associatedwith a higher risk of cataracts only (hazard ratio [HR], 4.98; P <.0001) whereas chronic graft-versus-host disease (cGVHD) was associated with an increased risk of cataracts (HR, 3.22; P 5 =0006), avascular necrosis (HR, 2.49; P 5 .006), and diabetes mellitus (HR, 3.36; P 5 =03). Estimated 10-year overall survival and leukemia-free survival were 73% and 70%, respectively, and did not differ on the basis of conditioning type. In conclusion, late effects among survivors of MAC HCT for AYA AML are frequent and are more closely linked to cGVHD than type of conditioning.",

author = "Lee, {Catherine J.} and Soyoung Kim and Tecca, {Heather R.} and Stephanie Bo-Subait and Rachel Phelan and Ruta Brazauskas and David Buchbinder and Hamilton, {Betty K.} and Minoo Battiwalla and Majhail, {Navneet S.} and Lazarus, {Hillard M.} and Shaw, {Peter J.} and Marks, {David I.} and Litzow, {Mark R.} and Saurabh Chhabra and Yoshihiro Inamoto and Zachariah DeFilipp and Hildebrandt, {Gerhard C.} and Olsson, {Richard F.} and Kasow, {Kimberly A.} and Liesveld, {Jane L.} and Rotz, {Seth J.} and Badawy, {Sherif M.} and Bhatt, {Neel S.} and Yared, {Jean A.} and Page, {Kristin M.} and Arellano, {Martha L.} and Michael Kent and Nosha Farhadfar and Sachiko Seo and Peiman Hematti and Freytes, {Cesar O.} and Alicia Rovo and Siddhartha Ganguly and Sunita Nathan and Linda Burns and Shaw, {Bronwen E.} and Muffly, {Lori S.}",

note = "Publisher Copyright: {\textcopyright} 2020 by The American Society of Hematology.",

year = "2020",

month = mar,

day = "24",

doi = "10.1182/bloodadvances.2019001126",

language = "English (US)",

volume = "4",

pages = "983--992",

journal = "Blood Advances",

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publisher = "American Society of Hematology",

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TY - JOUR

T1 - Late effects after ablative allogeneic stem cell transplantation for adolescent and young adult acute myeloid leukemia

AU - Lee, Catherine J.

AU - Kim, Soyoung

AU - Tecca, Heather R.

AU - Bo-Subait, Stephanie

AU - Phelan, Rachel

AU - Brazauskas, Ruta

AU - Buchbinder, David

AU - Hamilton, Betty K.

AU - Battiwalla, Minoo

AU - Majhail, Navneet S.

AU - Lazarus, Hillard M.

AU - Shaw, Peter J.

AU - Marks, David I.

AU - Litzow, Mark R.

AU - Chhabra, Saurabh

AU - Inamoto, Yoshihiro

AU - DeFilipp, Zachariah

AU - Hildebrandt, Gerhard C.

AU - Olsson, Richard F.

AU - Kasow, Kimberly A.

AU - Liesveld, Jane L.

AU - Rotz, Seth J.

AU - Badawy, Sherif M.

AU - Bhatt, Neel S.

AU - Yared, Jean A.

AU - Page, Kristin M.

AU - Arellano, Martha L.

AU - Kent, Michael

AU - Farhadfar, Nosha

AU - Seo, Sachiko

AU - Hematti, Peiman

AU - Freytes, Cesar O.

AU - Rovo, Alicia

AU - Ganguly, Siddhartha

AU - Nathan, Sunita

AU - Burns, Linda

AU - Shaw, Bronwen E.

AU - Muffly, Lori S.

PY - 2020/3/24

Y1 - 2020/3/24

N2 - There ismarkedpaucityofdata regarding late effects inadolescentsandyoungadults (AYAs)who undergo myeloablative conditioning (MAC) allogeneic hematopoietic cell transplantation (HCT) for acute myeloid leukemia (AML).We evaluated late effects and survival in 826 1-year diseasefree survivors of MAC HCT for AYA AML, with an additional focus on comparing late effects based upon MAC type (total body irradiation [TBI] vs high-dose chemotherapy only). The estimated 10-year cumulative incidence of subsequent neoplasms was 4% (95% confidence interval [CI], 2%-6%); 10-year cumulative incidence of nonmalignant late effects included gonadal dysfunction (10%; 95% CI, 8%-13%), cataracts (10%; 95% CI, 7%-13%), avascular necrosis (8%; 95% CI, 5%-10%), diabetes mellitus (5%; 95% CI, 3%-7%), and hypothyroidism (3%; 95% CI, 2%-5%). Receipt of TBIwas independently associatedwith a higher risk of cataracts only (hazard ratio [HR], 4.98; P <.0001) whereas chronic graft-versus-host disease (cGVHD) was associated with an increased risk of cataracts (HR, 3.22; P 5 =0006), avascular necrosis (HR, 2.49; P 5 .006), and diabetes mellitus (HR, 3.36; P 5 =03). Estimated 10-year overall survival and leukemia-free survival were 73% and 70%, respectively, and did not differ on the basis of conditioning type. In conclusion, late effects among survivors of MAC HCT for AYA AML are frequent and are more closely linked to cGVHD than type of conditioning.

AB - There ismarkedpaucityofdata regarding late effects inadolescentsandyoungadults (AYAs)who undergo myeloablative conditioning (MAC) allogeneic hematopoietic cell transplantation (HCT) for acute myeloid leukemia (AML).We evaluated late effects and survival in 826 1-year diseasefree survivors of MAC HCT for AYA AML, with an additional focus on comparing late effects based upon MAC type (total body irradiation [TBI] vs high-dose chemotherapy only). The estimated 10-year cumulative incidence of subsequent neoplasms was 4% (95% confidence interval [CI], 2%-6%); 10-year cumulative incidence of nonmalignant late effects included gonadal dysfunction (10%; 95% CI, 8%-13%), cataracts (10%; 95% CI, 7%-13%), avascular necrosis (8%; 95% CI, 5%-10%), diabetes mellitus (5%; 95% CI, 3%-7%), and hypothyroidism (3%; 95% CI, 2%-5%). Receipt of TBIwas independently associatedwith a higher risk of cataracts only (hazard ratio [HR], 4.98; P <.0001) whereas chronic graft-versus-host disease (cGVHD) was associated with an increased risk of cataracts (HR, 3.22; P 5 =0006), avascular necrosis (HR, 2.49; P 5 .006), and diabetes mellitus (HR, 3.36; P 5 =03). Estimated 10-year overall survival and leukemia-free survival were 73% and 70%, respectively, and did not differ on the basis of conditioning type. In conclusion, late effects among survivors of MAC HCT for AYA AML are frequent and are more closely linked to cGVHD than type of conditioning.

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VL - 4

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JO - Blood Advances

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ER -

Late effects after ablative allogeneic stem cell transplantation for adolescent and young adult acute myeloid leukemia

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