In a nutshell
This study aimed to investigate if consolidation chemotherapy before reduced-intensity conditioning (RIC) allogeneic hemopoietic stem cell transplant (alloHSCT) improved outcomes for patients with acute myeloid leukemia (AML).
This study concluded that exposure to consolidation chemotherapy before RIC alloHSCT may help patients who do not have an immediate donor available.
Some background
The first step in treating AML is induction chemotherapy. This kills leukemia cells and patients commonly enter remission. The most important part of AML treatment is alloHSCT. This consists of a transplant of stem cells from a donor. It helps to replace healthy cells that were damaged during chemotherapy and boosts the immune system.
However, not all patients have a donor available immediately after they enter remission. Consolidation treatment is usually given in patients that do not qualify for an alloHSCT after induction chemotherapy. It means to deepen the response of initial treatment and prevent relapse. Some patients receive induction chemotherapy at lower doses to reduce side effects. This is called RIC. In patients who receive RIC chemotherapy, consolidation chemotherapy may benefit patients before alloHSCT.
Methods & findings
This study involved 106 patients with AML in complete remission undergoing alloHSCT with RIC. Patients were divided into two groups based on whether they received consolidation chemotherapy before the transplant. Group 1 had 71 patients who received consolidation chemotherapy and group 2 had 35 who did not. The average follow-up was 33 months.
The average survival without relapse was 9 months for group 2 and 51 months for group 1. The average overall survival was 32 months for group 2 and was still ongoing for group 1.
A common complication after alloHSCT is graft versus host disease (GVHD). This is when the transplanted cells attack the patient. After 100 days, the rate of moderate to severe GVHD was 29% for group 2 compared to 20.5% for group 1.
The bottom line
This study concluded that consolidation chemotherapy before RIC alloHSCT was a good option for patients with AML who do not have an immediate donor available.
The fine print
This study was based on medical records. The patients were not randomly assigned to each group. This may have influenced the results.
Published By :
Therapeutic Advances in Hematology
Date :
May 08, 2021
