A recent study found that hematopoietic cell transplantation (HCT) significantly improved relapse-free survival (RFS) and overall survival (OS) at 5 years for patients over age 60 with acute myeloid leukemia (AML) classified in intermediate and unfavorable risk groups according to European LeukemiaNet (ELN)-2010.
Researchers from the French Innovative Leukemia Organization (FILO) analyzed the records of 521 consecutive patients from six centers, with median age of 65 years (range: 60-70). ELN risk was intermediate and unfavorable in 376 (72%) and 145 (28%) patients, respectively. Six months after first complete remission (CR1), a multistate model showed that patients who received HCT had a lower probability of relapse at 5 years compared to those who did not undergo HCT. (See results in chart below.)
Intermediate risk & HCT n=129 | Intermediate risk & no HCT n=247 | Unfavorable risk & HCT n=70 | Unfavorable risk & no HCT n=75 | P Value | |
| 5-year RFS | 50% | 16% | 44% | 7% | <0.001 |
| 5-year OS | 54% | 26% | 46% | 17% | <0.001 |
| 5-year relapse | 22% | 68% | 33% | 78% | <0.001 |
Results of the study were presented by Dr. Raynier Devillier from Aix-Marseille University, Marseille, France at the 2018 American Society of Hematology (ASH) Annual Meeting. Dr. Devillier concluded that for patients with AML who are over 60 years old, HCT improves outcomes in both intermediate and unfavorable ELN-sub-groups. Furthermore, without HCT, fewer than 10% of patients were able to achieve long-term disease-free survival.