Allogeneic HCT Better than Chemotherapy, Autologous HCT in Intermediate-Risk AML

A large-scale study of 630 intermediate-risk adults with acute myeloid leukemia (AML) in first complete remission who lack mutations of NPM1, FLT3-ITD, and CEBPA has shown that allogeneic hematopoietic cell transplantation (HCT) yields better outcomes than high-dose cytarabine-based chemotherapy or autologous transplantation. The study also showed comparable transplant outcomes regardless of donor type (matched sibling or unrelated donor). Patients studied were diagnosed with AML between 2000 and 2013, had a median age of 52 years (range 18-72), and had achieved a first complete remission (CR1) after one or two courses of standard induction therapy.

At a median follow up of 37 months, patients who underwent an allogeneic HCT in CR1 (n=396) had improved 3-year survival compared to those who received high-dose cytarabine based chemotherapy (n=189) or autologous transplant (n=45): 65% vs. 49%, respectively (p<0.001).

Esteve J, et al. Blood