High probability of long-term survival in 2-year survivors of autologous hematopoietic cell transplantation for AML in first or second CR.
We describe the long-term outcomes of autologous hematopoietic cell transplantation (HCT) for 315 AML patients in first or second complete remission (CR). All patients were in continuous CR for ≥2 years after HCT. Patients were predominantly transplanted in CR1 (78%) and had good or intermediate cytogenetic risk disease (74%). Median follow-up of survivors was 106 (range, 24-192) months. Overall survival at 10 years after HCT was 94% (95% confidence intervals, 89-97%) and 80% (67-91%) for patients receiving HCT in CR1 and CR2, respectively. The cumulative incidence of relapse at 10 years after HCT was 6% (3-10%) and 10% (3-20%) and that of nonrelapse mortality was 5% (2-9%) and 11% (4-21%), respectively. On multivariate analysis, HCT in CR2 (vs CR1), older age at transplantation and poor cytogenetic risk disease were independent predictors of late mortality and adverse disease-free survival. The use of growth factors to promote engraftment after HCT was the only risk factor for relapse. Relative mortality of these 2-year survivors was comparable to that of age-, race- and gender-matched normal population. Patients who receive autologous HCT for AML in CR1 or CR2 and remain in remission for ≥2 years have very favorable long-term survival. Their mortality rates are similar to that of the general population.
Majhail
N S
NS
Center for International Blood and Marrow Transplant Research, Minneapolis, MN 55455, USA. majha001@umn.edu
Bajorunaite
R
R
Lazarus
H M
HM
Wang
Z
Z
Klein
J P
JP
Zhang
M J
MJ
Rizzo
J D
JD
D000293:Adolescent; D000328:Adult; D002648:Child; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012074:Remission Induction / Q000379:methods; D016019:Survival Analysis; D017741:Survivors; D019172:Transplantation Conditioning; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult