Outcomes of allogeneic hematopoietic cell transplantation (allo-HCT) in patients with acute myeloid leukemia (AML) and second complete remission (CR2) have significantly improved over time, according to a study published online June 2 in Cancer.
Rama Al Hamed, M.D., from Sorbonne University in Paris, and colleagues investigated changes in patient- and transplant-related characteristics and posttransplant outcomes over time among 3,955 adult patients with AML receiving allo-HCT.
The researchers found that 725 patients were transplanted between 2005 and 2009, 1,600 between 2010 and 2014, and 1,630 between 2015 and 2019. Across time, there was a significant increase observed in patient age (from 48.7 to 53.5 years), use of a haploidentical donor (from 4.6 to 26.4 percent), and use of posttransplant cyclophosphamide (from 0.4 to 29 percent).
Over the same time period, there was a significant decrease observed in total body irradiation and in vivo T-cell depletion. Transplants performed more recently had better outcomes, with leukemia-free survival (hazard ratio [HR], 0.79) and overall survival (HR, 0.73) increasing over time and nonrelapse mortality decreasing over time (HR, 0.64). Graft-versus-host disease (GVHD) rates also improved (acute GVHD II-IV: HR, 0.78; GVHD-free, relapse-free survival: HR, 0.69).
“The best outcomes were with the use of a matched unrelated donor, given better leukemia-free survival, overall survival, and nonrelapse mortality, which helps to highlight that in the absence of a matched sibling donor, a matched unrelated donor could be a viable option for this patient population,” the authors write.
Several authors disclosed ties to the pharmaceutical industry.
Rama Al Hamed et al, Unrelated or haploidentical allogeneic hematopoietic cell transplantation in second complete remission for acute myeloid leukemia—Improved outcomes over time: A European Society for Blood and Marrow Transplantation Acute Leukemia Working Party study, Cancer (2023). DOI: 10.1002/cncr.34843
Source: Read Full Article