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. 2022 May 23;3(3):873-884.
doi: 10.1002/jha2.466. eCollection 2022 Aug.

The 17-gene stemness score associates with relapse risk and long-term outcomes following allogeneic haematopoietic cell transplantation in acute myeloid leukaemia

Dennis D H Kim  1   2 , Igor Novitzky Basso  1 , Taehyung Simon Kim  1   3   4 , Seong Yoon Yi  1   5 , Kyoung Ha Kim  1   6 , Tracy Murphy  1   2 , Steven Chan  1   2 , Mark Minden  1   2 , Ivan Pasic  1   2 , Wilson Lam  1   2 , Arjun Law  1   2 , Fotios V Michelis  1   2 , Armin Gerbitz  1   2 , Auro Viswabandya  1   2 , Jeffrey Lipton  1   2 , Rajat Kumar  1   2 , Stanley W K Ng  7 , Tracy Stockley  8   9   10 , Tong Zhang  8 , Ian King  8 , Jonas Mattsson  1   2   11 , Jean C Y Wang  2   1
Affiliations

The 17-gene stemness score associates with relapse risk and long-term outcomes following allogeneic haematopoietic cell transplantation in acute myeloid leukaemia

Dennis D H Kim et al. EJHaem. .

Abstract

A 17-gene stemness (LSC17) score determines risk in acute myeloid leukaemia patients treated with standard chemotherapy regimens. The present study further analysed the impact of the LSC17 score at diagnosis on outcomes following allogeneic haematopoietic cell transplantation (HCT). Out of 452 patients with available LSC17 score, 123 patients received allogeneic HCT. Transplant outcomes, including overall (OS), leukaemia-free survival (LFS), relapse incidence (RI) and non-relapse mortality (NRM), were compared according to the LSC17 scored group. The patients with a low LSC17 score had higher OS (56.2%) and LFS (54.4%) at 2 years compared to patients with high LSC17 score (47.2%, p = 0.0237 for OS and 46.0%, p = 0.0181 for LFS). The low LSC17 score group also had a lower relapse rate at 2 years (12.7%) compared to 25.3% in the high LSC17 score group (p = 0.017), but no difference in NRM (p = 0.674). Worse outcomes in the high LSC17 score group for OS, LFS and relapse were consistently observed across all stratified sub-groups. The use of more intensive conditioning did not improve outcomes for either group. In contrast, chronic graft-versus-host-disease was associated with more favourable outcomes in both groups. The 17-gene stemness score is highly prognostic for survival and relapse risk following allogeneic HCT.

Keywords: AML; Acute leukaemia; Gene expression; LSC 17 score; Stem cell transplantation.

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Conflict of interest statement

The authors declare they have no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Overview of the study cohorts and analysis
FIGURE 2
FIGURE 2
Transplant outcomes in overall patients according to LSC17 score
FIGURE 3
FIGURE 3
Sub‐group analysis of overall survival (A), leukaemia free‐survival (B), relapse incidence (C) and non‐relapse mortality (D). Hazard ratio and 95% confidence interval are shown for the high LSC17 score group across sub‐groups stratified by age, MRC cytogenetic risk group, complete remission status at HCT, conditioning regimen, stem cell source or T‐cell depletion
FIGURE 4
FIGURE 4
Simon–Makuch plot of overall survival considering time‐dependent variable of chronic GVHD in overall patients (A), in the low LSC17 score group (B) and in the high LSC17 score group (C), suggesting favourable effect of chronic GVHD on overall survival
See this image and copyright information in PMC

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