In a nutshell
This study aimed to investigate the post-hematopoietic (stem) cell transplant outcomes for older patients with AML in their second complete remission.
This study concluded that hematopoietic cell transplant is a good treatment option, especially for patients with favorable- or intermediate-cytogenetic risk status.
Acute myeloid leukemia (AML) occurs when abnormal myeloblasts are produced. Myeloblasts are a type of white blood cell that produce other cells. Abnormal myeloblasts cannot produce healthy cells. Lack of healthy cells can lead to a weak immune system, infection and bleeding.
An allogenic hematopoietic cell transplant (HCT) is a potential cure for older patients with AML in their first complete remission (no signs of cancer). It involves taking stem cells from a donor and putting them into the AML patient. Stem cells can produce any cell type and help to restore the immune system.
Cytogenetic-risk status is different for each patient and is thought to be a factor that can influence treatment outcomes.
It was not known what the outcomes for older patients in their second complete remission would be post-HCT and what influence cytogenetic-risk status would have.
Methods & findings
The aim of this study was to look at factors that influence the post-HCT outcomes in the second complete remission. This study involved 196 patients aged 60 and older who underwent HCT for AML in their second complete remission. 81% received reduced-intensity conditioning (chemotherapy) before HCT.
The three-year overall survival (OS, time from treatment until death from any cause) rate for patients who underwent HCT was 42%. The three-year leukemia-free survival rate for patients who underwent HCT was 37%.
The non-relapse mortality rate (death due to causes other than AML returning) for patients who underwent HCT was 25%. The relapse rate (cancer returns) was 38%.
Cytogenetic risk was the only factor that influenced OS. Patients with intermediate-risk cytogenetics were 14% more likely to have reduced OS. Patients with unfavorable-risk cytogenetics were 2.32 times more likely to have reduced OS.
Cytogenetic risk was the only factor that influenced the relapse rate. Patients with intermediate-risk cytogenetics were 10% more likely to have an increased relapse rate. Patients with unfavorable-risk cytogenetics were almost 3 times more likely to have an increased relapse rate.
The bottom line
This study concluded that allogeneic HCT is a treatment option for older patients with AML in their second remission that may be curative. Patients with favorable- or intermediate-cytogenetic risk are more likely to benefit.
The fine print
Larger studies need to be carried out.
Consult your physician about HCT as a treatment option for AML.
Published By :
Jun 01, 2017