Abstract
The present study evaluated outcomes and prognostic factors in adult patients with acute myeloid leukemia (AML) after syngeneic hematopoietic stem cell transplantation (HSCT). Among patients in first complete remission (CR1), outcomes of syngeneic HSCT (Syn) were compared with those of autologous HSCT (Auto), allogeneic HSCT from human leukocyte antigen (HLA)-matched sibling donor (MSD), or allogeneic HSCT from HLA-matched unrelated donor (MUD). Among 11,866 patients receiving first HSCT, 26 in the Syn group were analyzed. The 5-year overall survival (OS) rate, the cumulative incidence of relapse, and the cumulative incidence of non-relapse mortality (NRM) were 47.8%, 59.6%, and 4.6%, respectively. The OS was significantly better in patients in CR1 (n = 13) than in patients in non-CR1 (P = 0.012). Furthermore, 39 patients in CR1 each were assigned to the Auto, MSD, and MUD groups using propensity score matching. The 5-year OS in the Syn (68.4%) was not significantly different from those in the Auto (55.9%, P = 0.265), MSD (62.4%, P = 0.419), or MUD (63.7%, P = 0.409) groups. A higher relapse in the Syn than in the MSD and MUD groups was offset by lower NRM. In summary, syngeneic HSCT might be an alternative option for AML patients in CR1.
Highlights
Allogeneic hematopoietic stem cell transplantation (HSCT) is a potentially curative therapeutic option for acute myeloid leukemia (AML) [1,2,3,4,5,6,7]
In the absence of an matched sibling donor (MSD), there is an increased risk of non-relapse morbidity and mortality owing to graft-versus-host disease (GVHD), severe infections, and regimen-related toxicities, which are the major obstacles to allogeneic HSCT
In allogeneic HSCT, PBSCT is associated with rapid hematopoietic recovery, but controversies remain regarding survival, relapse, non-relapse mortality (NRM), and GVHD risks [31,32,33,34,35]
Summary
Allogeneic hematopoietic stem cell transplantation (HSCT) is a potentially curative therapeutic option for acute myeloid leukemia (AML) [1,2,3,4,5,6,7]. In the absence of an MSD, there is an increased risk of non-relapse morbidity and mortality owing to graft-versus-host disease (GVHD), severe infections, and regimen-related toxicities, which are the major obstacles to allogeneic HSCT. Autologous HSCT is an alternative post-remission treatment, which has been shown to reduce the risk of transplant-related morbidity and mortality [8,9,10,11,12,13]. A relatively high risk of relapse is a major problem owing to the lack of a graft-versus-leukemia effect by allogeneic cells and the potential contamination of the graft with leukemic cells. Limited data are available comparing the outcomes of syngeneic HSCT with those of autologous or allogeneic HSCT [17]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
