title: 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.
abstract: 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.
authors.affiliation: Department of Haematology, Singapore General Hospital, Singapore. yvonne.loh.s.m@sgh.com.sg
authors.forename: Yvonne Su Ming
authors.initials: YS
authors.lastname: Loh
authors.forename: Liang Piu
authors.initials: LP
authors.lastname: Koh
authors.forename: Bee Choo
authors.initials: BC
authors.lastname: Tai
authors.forename: William Ying Khee
authors.initials: WY
authors.lastname: Hwang
authors.forename: Yeh Ching
authors.initials: YC
authors.lastname: Linn
authors.forename: Yeow Tee
authors.initials: YT
authors.lastname: Goh
authors.forename: Patrick Huat Chye
authors.initials: PH
authors.lastname: Tan
mesh_terms: 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