This large-scale study of 1,231 patients with acute myeloid leukemia (AML) relapsing after allogeneic HCT during first or second complete remission has identified several factors associated with longer post-relapse survival. Researchers compared patient transplant outcomes between 1990 and 2010 reported to CIBMTR who at relapse received chemotherapy alone (n=660), donor lymphocyte infusion (DLI) with or without chemotherapy (n=202), or a second allogeneic HCT with or without chemotherapy and with or without DLI (n=369). Survival for all patients was 23% at 1 year after relapse, but 3-year overall survival correlated with time from HCT to relapse: 4%, 12%, 26%, and 38% for relapse at 1-6 months, 6-24 months, 24-36 months, and ≥36 months, respectively. A multivariate analysis revealed that patients who benefited most from DLI and a second HCT were those relapsing 6 months and later after their initial transplant.
Survival of Patients with AML Relapsing after Allogeneic HCT