Cytogenetic Abnormalities and Their Impact on Acute Myeloid Leukemia Outcomes Following Allogeneic Hematopoietic Stem Cell Transplantation: A Single‐Center Retrospective Study

TL;DR

This study examines how genetic abnormalities affect survival outcomes in Iranian patients with acute myeloid leukemia who undergo stem cell transplants.

Contribution

The study identifies specific cytogenetic risk groups and their impact on survival outcomes in an Iranian AML cohort post-HSCT.

Findings

Patients with −7, 7q abnormalities, +8, complex karyotype, and monosomal karyotype had shorter overall survival.

Normal karyotype, inversion (16), and t(16;16) were associated with intermediate survival outcomes.

Adverse cytogenetic profiles significantly correlated with shorter leukemia-free survival.

Abstract

Cytogenetic abnormalities at diagnosis are detected in over half of adult patients with acute myeloid leukemia (AML). This study aimed to evaluate the impact of these abnormalities on the outcomes of AML patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT) in an Iranian cohort.

This retrospective study included 206 AML patients aged over 15 who underwent allogeneic HSCT at a single center. Cytogenetic abnormalities were identified from medical records, and survival outcomes, including overall survival (OS) and leukemia‐free survival (LFS), were assessed across different cytogenetic risk groups. Multivariable analyses were adjusted for age, sex, donor type, time from diagnosis to transplant, and disease status at transplant.

The median follow‐up duration was 46.75 months. 1‐, 3‐, and 5‐year OS rates were 80.0%, 65.9%, and 58.5%, respectively, with significant differences based on cytogenetic risk. Patients with −7, 7q abnormalities, +8, complex karyotype, and monosomal karyotype exhibited shorter OS, classifying them as adverse‐risk. Patients with normal karyotype, inversion (16), and t(16;16) were intermediate‐risk. LFS at 1, 3, and 5 years was 74.6%, 64.5%, and 54.1%, respectively, with adverse cytogenetic profiles significantly associated with shorter LFS.

This study demonstrates the prognostic significance of cytogenetic profiles in Iranian AML patients post‐HSCT. Results underscore the importance of cytogenetic stratification in guiding treatment decisions, suggesting that risk‐adapted guidelines may benefit specific populations. Future prospective studies on survival outcomes in Iranian AML patients could refine evidence‐based treatment guidelines.

Figures