{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T01:22:12Z","timestamp":1792027332811,"version":"4.4.0"},"reference-count":22,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"17","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO"],"published-print":{"date-parts":[[2025,6,10]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>Hematopoietic stem cell transplantation (HSCT) is used as consolidation for pediatric patients with high-risk AML in first complete remission (CR1). The definition of high-risk AML has evolved considerably over the past two decades with the successive identification of new unfavorable risk factors. We conducted a cross-study analysis to determine whether HSCT improves the outcomes of patients with contemporarily defined high-risk AML.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We combined data from AAML0531 and AAML1031, the last two phase III clinical trials completed by the Children's Oncology Group (COG). These two trials established the prognostic importance of measurable residual disease (MRD) and several high-risk cryptic cytogenetic\/molecular (CM) alterations, which were applied to reclassify patients in the current COG phase III clinical trial, AAML1831. We compared the outcomes after HSCT in CR1 with those after chemotherapy alone in CR1 in the redefined high-risk group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Our study cohort comprised 463 patients with high-risk CM alterations and 72 patients with standard-risk (SR) CM results with positive MRD at end of induction I. In all, 33.9% and 45.8% of these groups underwent HSCT in CR1, respectively. HSCT was associated with decreased relapse and improved disease-free survival (DFS) in both groups. In the high-risk CM group, 5-year DFS was 26.0% (95% CI, 20.6 to 31.6) and 49.8% (95% CI, 41.7 to 57.4;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001) in patients receiving chemotherapy alone and HSCT, respectively. In the SR CM and MRD+ groups, DFS was 16.9% (95% CI, 4.3 to 36.7) compared with 50.9% (95% CI, 32.7 to 66.5;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .032). HSCT was also associated with improvement in outcomes based on multivariable analysis and across subgroups defined by clinical trial and by high-risk CM subtype, with the exception of chromosome 7 or 5 loss.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>HSCT was associated with improved outcomes in pediatric patients with contemporarily defined high-risk AML.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/jco-24-01841","type":"journal-article","created":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T15:59:10Z","timestamp":1745855950000},"page":"1961-1971","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":15,"title":["Hematopoietic Stem Cell Transplantation Outcomes for High-Risk AML: A Report From the Children's Oncology Group"],"prefix":"10.1200","volume":"43","clinical-trial-number":[{"clinical-trial-number":"nct01371981","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct00372593","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6996-0833","authenticated-orcid":true,"given":"Benjamin J.","family":"Huang","sequence":"first","affiliation":[{"name":"Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA"},{"name":"Deceased"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren K.","family":"Meyer","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Washington, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd A.","family":"Alonzo","sequence":"additional","affiliation":[{"name":"Department of Population and Public Health Sciences, University of Southern CA, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Cheng","family":"Wang","sequence":"additional","affiliation":[{"name":"Children's Oncology Group, Monrovia, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7781-2918","authenticated-orcid":true,"given":"Adam J.","family":"Lamble","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Seattle Children's Hospital, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rhonda E.","family":"Ries","sequence":"additional","affiliation":[{"name":"Fred Hutchinson Cancer Center, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4509-5248","authenticated-orcid":true,"given":"Weijie","family":"Wang","sequence":"additional","affiliation":[{"name":"Deceased"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Betsy","family":"Hirsch","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gordana","family":"Raca","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaotu","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Computational Biology, St Jude Children's Research Hospital, Memphis, TN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1513-2893","authenticated-orcid":true,"given":"Alan S.","family":"Gamis","sequence":"additional","affiliation":[{"name":"Children's Mercy Hospitals and Clinics, Kansas City, MO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7482-5644","authenticated-orcid":true,"given":"Richard","family":"Aplenc","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania School of Medicine, Philadelphia, PA"},{"name":"Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2854-9014","authenticated-orcid":false,"given":"E. Anders","family":"Kolb","sequence":"additional","affiliation":[{"name":"Leukemia and Lymphoma Society, Rye Brook, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1203-2371","authenticated-orcid":true,"given":"Todd M.","family":"Cooper","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Seattle Children's Hospital, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9717-2973","authenticated-orcid":true,"given":"Katherine","family":"Tarlock","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Seattle Children's Hospital, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0335-9065","authenticated-orcid":true,"given":"Michael R.","family":"Loken","sequence":"additional","affiliation":[{"name":"Hematologics, Inc, Seattle, 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