Allogeneic hematopoietic stem cells transplantation improves the survival of intermediate-risk acute myeloid leukemia patients aged less than 60years

作者：Zhang, Ying; Zhang, Yimin; Chen, Qi; Tang, Gusheng; Zhang, Weiping; Yang, Jianmin; Wang, Jianmin; Hu, Xiaoxia^*

来源：Annals of Hematology, 2019, 98(4): 997-1007.

DOI：10.1007/s00277-018-3584-2

• Acute myeloid leukemia
• Intermediate risk
• Postremission therapy
• Allogeneic hematopoietic stem cell transplantation
• NPM1(mut-neg)CEBPA(dm-neg)FLT3-ITDneg

The prognosis of acute myeloid leukemia (AML) with normal karyotype is further determined by specific genetic alterations. The optimal post-remission therapy (PRT) in younger patients within this group after first complete remission (CR1) remains to be determined. We report a retrospective evaluation of PRT approaches in 223 patients under the age of 60years old with intermediate-risk AML in CR1. Patients receiving allogenic hematopoietic stem cell transplantation (alloHSCT) obtained improved overall survival (OS) than patients who treated with chemotherapy (5-year 61.6 +/- 5.2% versus 41.1 +/- 5.3%, p=0.004). AlloHSCT led to fewer cases of relapse (hazard ratio [HR] 0.14, p<0.001) and increased the relapse-free survival (RFS, HR 0.45, p<0.001). With alloHSCT, the outcome of patients who reached negative minimal residual disease after 2cycles of consolidation could be further improved with an increased OS of 66% and RFS of 61%. Nucleophosmin-1 (NPM1) mutation negative, CCAAT/enhancer binding protein alpha (CEBPA) double mutation negative, and FLT-3 internal tandem duplication negative (NPM1(mut-neg)CEBPA(dm-neg)FLT3-ITDneg) patients had a significantly longer RFS with alloHSCT. In conclusion, our results provide additional evidence that alloHSCT is preferential PRT in patients with intermediate-risk AML that are under the age of 60years old in CR1.

• 出版日期2019-4
• 单位中国人民解放军第二军医大学