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

BACKGROUND AND AIMS

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.