In a nutshell
This study aimed to compare post-remission therapies for older patients with acute myeloid leukemia who are in complete remission.
This study concluded that stem cell transplantation is more effective as a post-remission therapy than consolidation chemotherapy, but with more risks early-on.
Some background
Post-remission therapy is given after cancer has disappeared following initial therapy. It can also be called consolidation therapy and intensification therapy. It aims to kill any cancer cells that may remain in the body.
Allogenic hematopoietic stem cell transplantation (allo-HSCT) is a procedure in which a person receives blood-forming stem cells from a genetically similar, but not identical, donor. This is often a sister or brother. It could also be from an unrelated donor. Consolidation chemotherapy (CC) is chemotherapy given once remission is achieved. Both allo-HSCT and CC are post-remission therapies.
It is not known what the preferred post-remission therapy for older AML patients in complete remission is.
Methods & findings
This study involved 642 patients aged 60-77 years, in complete remission, with AML. 67% (431) of patients received allo-HSCT as a post-remission therapy. 33% (211) of patients received CC.
Patients in the allo-HSCT group more frequently had high-risk AML when compared to the patients in the CC group. Overall survival (OS) was worse in the allo-HSCT group (when compared to the CC group) during the first 9 months after complete remission. However, it beyond 9 months, allo-HSCT patients were 47% more likely to have a better OS than the CC group. Treatment-related mortality (TRM) following allo-HSCT was worse in the first 9 months. However, relapse after allo-HSCT was less frequent beyond 9 months. Allo-HSCT patients had a 5-year OS of 28.6% compared to 13.8% in the CC group.
The bottom line
This study concluded that allo-HSCT had reduced relapse and superior long-term survival when compared to CC in older patients with AML in complete remission. However, the short-term risk of mortality was higher with allo-HSCT.
The fine print
This study was based on medical records. Some information was missing. This might have influenced the results.
Published By :
Leukemia
Date :
May 09, 2019
