Background: Allogeneic hematopoietic stem cell transplantation (HSCT) is a well-established curative treatment option for acute myeloid leukemia (AML) in second complete remission (CR2). However, whether the addition of consolidation chemotherapy after achieving CR2 can improve transplant outcomes remains controversial.Methods: In this single-center retrospective study, we analyzed consecutive AML patients who underwent their first HSCT in CR2 at our institution between January 2015 and December 2019.Results: For the consolidation (n= 72) and no consolidation groups (n= 63), the 5-year cumulative incidence of relapse (CIR) was (17.6% vs. 19.9%;p= 0.54), the 5-year non-relapse mortality rate (NRM) was (9.7% vs. 17.5%;p= 0.20), the 5-year leukemia-free survival (LFS) was (72.7% vs. 62.7%;p= 0.15), and the 5-year overall survival (OS) was (81.9% vs. 68.3%;p= 0.08). Additional consolidation therapy to achieve negative measurable residual disease (MRD) did not result in significantly improved outcomes compared to immediate HSCT in MRD positive status, with similar LFS (76.9% vs. 67.0%,p= 0.2) and OS (88.3% vs. 75.0%,p= 0.14). Multivariable analysis indicated that consolidation chemotherapy did not significantly affect CIR, NRM, LFS, or OS.Conclusions: Our findings suggest no significant differences in clinical outcomes between the groups, indicating that AML patients in CR2 might proceed to HSCT without delay.
背景：异基因造血干细胞移植（HSCT）是急性髓系白血病（AML）患者在第二次完全缓解（CR2）阶段公认的根治性治疗方案。然而，在达到CR2后增加巩固化疗是否能改善移植效果仍存在争议。 方法：在这项单中心回顾性研究中，我们分析了2015年1月至2019年12月期间在我院首次于CR2期接受HSCT的连续AML患者。 结果：在巩固化疗组（n=72）与无巩固化疗组（n=63）中，5年累积复发率（CIR）分别为（17.6% vs. 19.9%；p=0.54），5年非复发死亡率（NRM）分别为（9.7% vs. 17.5%；p=0.20），5年无白血病生存率（LFS）分别为（72.7% vs. 62.7%；p=0.15），5年总生存率（OS）分别为（81.9% vs. 68.3%；p=0.08）。与在可测量残留病灶（MRD）阳性状态下立即进行HSCT相比，通过额外巩固治疗达到MRD阴性并未显著改善临床结局，两组LFS（76.9% vs. 67.0%，p=0.2）和OS（88.3% vs. 75.0%，p=0.14）均无显著差异。多变量分析表明，巩固化疗对CIR、NRM、LFS或OS均无显著影响。 结论：我们的研究结果显示两组间临床结局无显著差异，表明CR2期AML患者可能无需延迟可直接进行HSCT。
肿瘤(癌症)患者之家