Comparison of allogeneic hematopoietic cell transplantation and chemotherapy in elderly patients with non-M3 acute myelogenous leukemia in first complete remission.
The benefits of allogeneic hematopoietic cell transplantation (allo-HCT) for patients with acute myelogenous leukemia (AML) in first complete remission (CR1) have mostly been evaluated in younger patients. Although favorable outcomes of allo-HCT over chemotherapy have been reported with the use of reduced-intensity conditioning (RIC) regimens in elderly patients with AML in CR1, information is still limited, especially on the effects of cytogenetic risks and donor sources. We collected data from AML patients aged 50 to 70 years who achieved CR1, and compared the outcome in 152 patients who underwent allo-HCT in CR1 (HCT group) to that in 884 patients who were treated with chemotherapy (CTx group). The cumulative incidence of relapse in the HCT group was significantly lower than that in the CTx group (22% versus 62%). Both overall survival (OS) and relapse-free survival (RFS) were significantly improved in the HCT group (OS: 62% versus 51%, P = .012), not only in the whole population, but also in the intermediate-risk group. Among patients who had a suitable related donor, the outcomes in the HCT group were significantly better than those in the CTx group. The introduction of appropriate treatment strategies that include allo-HCT may improve the outcome in elderly patients with AML in CR1.
Kurosawa
Saiko
S
Stem Cell Transplantation Division, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan.
Yamaguchi
Takuhiro
T
Uchida
Naoyuki
N
Miyawaki
Shuichi
S
Usuki
Kensuke
K
Watanabe
Masato
M
Yamashita
Takuya
T
Kanamori
Heiwa
H
Tomiyama
Junji
J
Nawa
Yuichiro
Y
Yano
Shingo
S
Takeuchi
Jin
J
Yakushiji
Kazuaki
K
Sano
Fumiaki
F
Uoshima
Nobuhiko
N
Yano
Takahiro
T
Nannya
Yasuhito
Y
Moriuchi
Yukiyoshi
Y
Miura
Ikuo
I
Takaue
Yoichi
Y
Fukuda
Takahiro
T
D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D020732:Cytogenetic Analysis; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006648:Histocompatibility; D006801:Humans; D007564:Japan; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012074:Remission Induction; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D014184:Transplantation, Homologous
D000970:Antineoplastic Agents