Abstract
Abstract 4161
The role of HLA-haploidentical related donors (HRD) hematopoietic stem-cell transplantation (HSCT) in first complete remission (CR1) for adults with intermediate and poor risk acute myeloid leukemia (AML) is still not clear.
Totally 428 newly diagnosed AML patients between 15 and 60 years old were studied between Jan 2006 and May 2010. Among 240 patients with intermediate and poor risk cytogenetics, 191patients achieved CR1 and received chemotherapy alone or HSCT as post-remission treatment. Of these, 141 patients received chemotherapy alone (n=78) or HRD HSCT (n=63) were analyzed.
Up to last follow-up time of May 2011, 44 out of 141 patients died (36 died of relapse and 8 died of TRM) and 97 patients are still alive. 49 out of 141 patients experienced relapse and 84 patients are still in continuous CR1. The cumulative incidence of relapse (CIR) at 4 years was 37.4%±4.4%. Overall survival(OS) and disease-free survival(DFS) at 4 year was 63.8%±5.0% and 55.5%±4.9%, respectively. The CIR of HRD HSCT group was significantly lower than chemotherapy group(12.8%±6.1% vs.57.4%±5.6%, p<0.0001). HRD HSCT improved survival achieved by chemotherapy alone significantly (DFS at 4 years, 71.8%±6.9% v 42.6%±6.1%, p<0.0001;OS at 4 years,75.7% ±7.0% v 54.6%±6.1%, p=0.0014). Univariate and multivariate analysis showed post-remission treatment choice (HRD HSCT or chemotherapy) and high WBC at diagnosis were independent risk factor affecting relapse, DFS and OS.
HRD HSCT in CR1 is superior to chemotherapy alone for adults with intermediate and poor risk AML patients.
No relevant conflicts of interest to declare.
Author notes
Asterisk with author names denotes non-ASH members.
