Comparing Chemotherapy to Allo-HCT in Post-Remission AML
Allogeneic hematopoietic cell transplantation (HCT) is “the most potent post-remission therapy for AML,” according to the results of a multi-center, prospective matched pairs analysis of 185 adult patients with AML. Projected seven year survival was 58% vs. 46% in the HCT group and the chemotherapy group, respectively (p=0.037), and relapse-free survival was 52% vs. 33%, respectively (p<0.001). Patients received either conventional post-remission chemotherapy or allogeneic HCT using a related or unrelated donor. Main matching criteria were AML type, patient age, cytogenetic risk group, and time in first complete remission. Overall survival was significantly better within cohorts of allo-HCT patients with high risk cytogenetics, older than 45 years, and with secondary AML or high-risk myelodysplastic syndrome.