Retrospective Analysis of Post-Remission Modalities in AML Patients with Normal Karyotype.

Background: Cytogenetics is considered as the most important factor to determine type of post-remission treatment in patients with AML However, there are controversy regarding to select consolidation modality in the intermediate risk group because of heterogeneity. We compared the outcome of patients with normal karyotype according to the different consolidation modalities.

Methods: AML patients with normal karyotype who achieved complete remission (CR) and did not have any contraindication for SCT, were included. The outcomes were retrospectively analyzed according to consolidation treatments.

Result: Among 51 patients who achieved CR, 35 patients underwent stem cell transplantation (SCT; 27 HLA-matched allogeneic and 8 autologous SCT), while 16 patients received high-dose cytarabine chemotherapy (HDAC) for consolidation therapy. No differences in the patient characteristics were observed. The estimated relapse rate at 3 years was significantly lower in the SCT group (38.6 vs. 75.6%, p=0.010). The DFS was significantly higher in the SCT group (HR=0.360; 95%CI=0.161–0.870; p=0.013), while OS was insignificantly higher in the SCT group (HR=0.489; 95%CI=0.199–1.205; p=0.120). There were no differences in DFS and OS between allogeneic and autologous SCT (p=0.714 and 0.515, respectively)

Conclusion: SCT showed a better survival outcome than chemotherapy alone as post-remission therapy in AML patients with normal chromosome. Considering late complications like GVHD, auto-SCT might be a feasible option for post-remission therapy in patients with normal karyotype.