Long-term follow-up of Asian patients younger than 46 years with acute myeloid leukemia in first complete remission: comparison of allogeneic vs. autologous hematopoietic stem cell transplantation.
Optimal therapy for patients with acute myeloid leukemia (AML) in first complete remission (CR-1) remains the subject of debate: with the possibilities of chemotherapy alone, autologous (auto) or allogeneic (allo) hematopoietic stem cell transplantation (HSCT). We undertook a retrospective analysis of AML patients aged below 46 years and in CR-1, who had undergone auto- or allo-HSCT in our institution, to determine the factors associated with a better outcome. Between September 1985 and April 2003, 81 patients underwent autologous (n = 29) or allogeneic (n = 52) HSCT in CR-1. With a median follow-up of 10 years, the probability of 15-year overall survival (OS) was 51%[95% confidence interval (CI) = 32 - 70%] for auto-HSCT vs. 55% (95% CI = 42 - 69) for allo-HSCT, respectively (P = 0.92). The cumulative incidence of relapse at 3 years was 49% (95% CI = 30 - 67) (auto) vs. 21% (95% CI = 10 - 30) (allo), respectively. Non-relapse-related mortality at 3 years was 5% (95% CI = 0 - 14) (auto) vs. 17% (95% CI = 7 - 28) (allo), respectively. This retrospective analysis confirmed that auto- and allo-HSCT led to similar OS. The significantly lower incidence of relapse amongst allograft recipients was balanced by an increased incidence of death in CR.
Loh
Yvonne Su Ming
YS
Department of Haematology, Singapore General Hospital, Singapore. yvonne.loh.s.m@sgh.com.sg
Koh
Liang Piu
LP
Tai
Bee Choo
BC
Hwang
William Ying Khee
WY
Linn
Yeh Ching
YC
Goh
Yeow Tee
YT
Tan
Patrick Huat Chye
PH
D000208:Acute Disease; D000328:Adult; D044466:Asian People; D002423:Cause of Death; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D007951:Leukemia, Myeloid / Q000628:therapy*; D011379:Prognosis; D012008:Recurrence; D012074:Remission Induction; D016019:Survival Analysis; D014182:Transplantation, Autologous / Q000009:adverse effects; D014184:Transplantation, Homologous / Q000009:adverse effects