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ASH 2025 | The impact of tumor burden on transplantation outcomes in AML
Arnon Nagler, MD, Chaim Sheba Medical Center, Tel Aviv, Israel, comments on the impact of tumor burden on transplantation outcomes in acute myeloid leukemia (AML). Prof. Nagles notes that patients who achieve remission after one course of induction generally have better outcomes compared with those who achieve remission after two inductions, although this does not apply to cord blood transplants. This interview took place at the 67th ASH Annual Meeting and Exposition, held in Orlando, FL.
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Transcript
Tumor burden is important in transplantation, and one of the parameters that we published in many types of transplant, in sibling transplant, in unrelated transplantation, and also in haploidentical transplant, was that patients that achieved remission after one course of induction did better as for transplantation outcome compared to the patients that achieved remission but after two inductions...
Tumor burden is important in transplantation, and one of the parameters that we published in many types of transplant, in sibling transplant, in unrelated transplantation, and also in haploidentical transplant, was that patients that achieved remission after one course of induction did better as for transplantation outcome compared to the patients that achieved remission but after two inductions. So actually, I mean, if you achieve remission faster after the first induction, you do better in transplantation. And the only exclusion for this was cord blood transplant. So in cord blood transplant, we were not able to show that if you achieve it. So if you achieve the CR after one or two inductions, it was the same, and this speaks for the different biology of cord blood transplantation. But this was always conventional anti-GVHD prophylaxis, and now we wanted to see if this is also true with post-transplant cyclophosphamide, because post-transplant cyclophosphamide changed the biology of the transplantation. And indeed, in patients that receive PTCy for this study here, there was no difference. If you achieve the CR after one or two inductions, the transplantation outcome at large was the same. So if you achieve remission, it doesn’t matter if you do it after first induction or second induction, if you go for transplant with post-transplant cyclophosphamide.
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