Hematopoietic Cell Transplantation May Be Effective for High-Risk Acute Myeloid Leukemia

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Hematopoietic cell transplantation (HCT) may be an effective treatment for patients with high-risk acute myeloid leukemia (AML), according to a study published in Leukemia.

Researchers led by Johannes Schetelig, DKMS, of the German Bone Marrow Donor Center in Dresden  examined 1,179 patients with intermediate- to high-risk AML. Allogeneic HCT was recommended in high-risk AML to be administered for aplasia after induction chemotherapy.

Patients were also randomized to one of two groups: a control group involved sibling HCT in first complete remission as well as matched, unrelated HCT in complex karyotype AML, or an experimental group where matched, unrelated HCT in first remission was also offered to patients with FMS-like tyrosine kinase 3-internal tandem duplication.

The researchers found that overall survival was significantly improved in high-risk patients after allogeneic HCT in aplasia and after HCT in remission. As-treated analysis also suggested a profound effect of allogeneic HCT on overall survival and even-free survival.

“Although superiority of one study arm could not be demonstrated in the intent-to-treat analaysis, secondary analysis suggest that early allogeneic HCT is a promising strategy for patients with high-risk AML,” the authors concluded.

FCR remains standard of care in very fit patients with chronic lymphocytic leukemia.
Hematopoietic cell transplantation may be an effective treatment for patients with high-risk acute myeloid leukemia.
The optimal timing of allogeneic hematopoietic stem cell transplantation (HCT) in acute myeloid leukemia (AML) is controversial. Although superiority of one study arm could not be demonstrated in the ITT analysis, secondary analyses suggest that early allogeneic HCT is a promising strategy for patients with high-risk AML.
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