A recent study revealed that patients with acute myeloid leukemia (AML) who underwent hematopoietic cell transplantation (HCT) in recent years have experienced better outcomes, including significantly improved overall survival (OS).
Researchers compared outcomes for 4,763 patients who underwent transplant from 1993-2002 to 15,424 patients who underwent transplant from 2003-2007 and 2008-2012. They found that leukemia-free survival (LFS) rates were significantly improved in more recently transplanted patients compared to patients transplanted in 1993-2002, a benefit which also extended to improved OS and decreased non-relapse mortality (NRM) rates. (See chart below.)
HR= hazard ratio, CI = confidence interval
The number of patients undergoing transplant with poor-risk cytogenetics rose from 13% to 22% (p<0.0001); these patients did not experience significant improvement in relapse rates during the study periods. However, analysis of patients in the early HCT cohort showed that intermediate risk cytogenetics was a significant risk factor for relapse but this risk was no longer evident for patients in the most recent time period.
Even with significantly improved survival and decrease in non-relapse mortality, relapse prevention remains challenging for patients with AML. Targeted agents and immunotherapies continue to be investigated as strategies to improve outcomes