The effects of stem cell transplant on multiple relapses in acute myeloid leukemia.

This study analyzed the outcomes of allogeneic stem cell transplantation (alloSCT) in patients with acute myeloid leukemia (AML) who had experienced multiple relapses. The main finding was that those who received alloSCT while in complete remission for at least the third time had the best survival.  

Complete remission means that tests, physical exams, and scans show that all signs of a cancer is gone. Relapse means that a cancer has returned after a time of remission. Many patients with AML experience complete remission and may never relapse. However, some patients may experience relapse multiple times. The outcomes associated with multiple relapses are sometimes unfavorable. Stem cell transplant has been considered as an effective treatment for AML after multiple relapses. It is important to research the outcomes after an alloSCT (healthy stem cells from a donor) of patients with AML who had multiple relapses.

This study investigated the medical records of patients with AML who had undergone an alloSCT. Only those who had received a transplant with stem cells from an umbilical cord were included. 192 patients included were in complete remission for the 3^rd time at least. 300 were experiencing relapse for the 2^nd time. 50 were experiencing relapse for at least the 3^rd time.

Those who received a transplant when in remission for at least the 3^rd time had the best survival after 4 years (48%). This was compared to 21% in those who received a transplant during 2^nd relapse and 12% of those who received a transplant during the at least the 3^rd relapse.

Those in complete remission for at least the 3^rd time were less likely to experience relapse (23% versus 57% in 2^nd relapse and 52% in relapse for at least the 3^rd time). 

This study concluded that patients with AML who received an alloSCT while in complete remission for at least the 3^rd time had the best outcomes.

This study included patients from Japan only. Therefore the results may not apply to patients elsewhere. Further studies are needed.