Comparative therapeutic value of post-remission approaches in patients with acute myeloid leukemia aged 40–60 years
- 27 November 2014
- journal article
- research article
- Published by Springer Science and Business Media LLC in Leukemia
- Vol. 29 (5), 1041-1050
- https://doi.org/10.1038/leu.2014.332
Abstract
The preferred type of post-remission therapy (PRT) in patients with acute myeloid leukemia (AML) in first complete remission (CR1) is a subject of continued debate, especially in patients at higher risk of nonrelapse mortality (NRM), including patients >40 years of age. We report results of a time-dependent multivariable analysis of allogenic hematopoietic stem cell transplantation (alloHSCT) (n=337) versus chemotherapy (n=271) or autologous HSCT (autoHSCT) (n=152) in 760 patients aged 40–60 years with AML in CR1. Patients receiving alloHSCT showed improved overall survival (OS) as compared with chemotherapy (respectively, 57±3% vs 40±3% at 5 years, PPP=0.029) as compared with autoHSCT in intermediate-risk AMLs. AlloHSCT was applied following myeloablative conditioning (n=157) or reduced intensity conditioning (n=180), resulting in less NRM, but comparable outcome with respect to OS, RFS and relapse. Collectively, these results show that alloHSCT is to be preferred over chemotherapy as PRT in patients with intermediate- and poor-risk AML aged 40–60 years, whereas autoHSCT remains a treatment option to be considered in patients with intermediate-risk AML.This publication has 56 references indexed in Scilit:
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