Superior outcome of patients with favorable-risk acute myeloid leukemia using consolidation with autologous stem cell transplantation.
Ofrat Beyar-KatzNoa LaviShimrit Ringelstein-HarlevIsrael HenigDana Yehudai-OfirNuhad HaddadRiva FinemanYishai OfranYuval NovDvora SaharNivin Moustafa-HawashJacob M RoweTsila ZukermanPublished in: Leukemia & lymphoma (2019)
Autologous stem cell transplantation (ASCT), intensifying anti-leukemic effects without significant treatment-related mortality (TRM), is particularly appealing in AML with favorable genetic/molecular profile. This study retrospectively evaluated the outcomes of post-remission treatment in consecutive favorable-risk AML patients. Sixty-six patients were included: 32 had mutated NPM1/wild-type FLT-ITD, 16 had t(8:21) and 18 - inv(16). Forty patients received chemotherapy alone, 26 underwent ASCT upfront. In time-dependent analysis, the ASCT group demonstrated higher relapse-free (RFS) (p = .001) and overall survivals (OS) (p = .0007). The 1-year RFS and OS were 44.2% vs 88% and 71% vs 96% for chemotherapy and ASCT, respectively. The corresponding TRM was 4/40 (10.0%) and 0/26 (0%), with relapse rates of 70.0% and 19.2% (p = .0002). In multivariate analysis, ASCT was associated with superior OS and RFS. In conclusion, ASCT offers significantly superior RFS and OS in favorable-risk AML in first complete remission. These data support the recent resurgence of interest in ASCT for AML.
Keyphrases
- acute myeloid leukemia
- stem cell transplantation
- end stage renal disease
- ejection fraction
- newly diagnosed
- allogeneic hematopoietic stem cell transplantation
- prognostic factors
- peritoneal dialysis
- stem cells
- patient reported outcomes
- radiation therapy
- adipose tissue
- squamous cell carcinoma
- mesenchymal stem cells
- disease activity
- cardiovascular disease
- coronary artery disease
- combination therapy
- patient reported
- chemotherapy induced