Effect of consolidation before allogeneic hematopoietic stem cell transplantation for non-favorable acute myeloid leukemia patients with first complete remisson and negative minimal residual disease

Yimin Zhang; Ying Zhang; Xiong NI; Lei Gao; Huiying Qiu; Yuesheng Zhang; Gusheng Tang; Jie Chen; Weiping Zhang; Jianmin Wang; Jianmin Yang; Xiaoxia HU

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Effect of consolidation before allogeneic hematopoietic stem cell transplantation for non-favorable acute myeloid leukemia patients with first complete remisson and negative minimal residual disease

VernacularTitle: 异基因造血干细胞移植前巩固化疗对第一次形态学完全缓解且微小残留病阴性中/高危急性髓系白血病患者预后的影响
Author: Yimin ZHANG ^{1
,

2} ; Ying ZHANG ^{1
,

2} ; Xiong NI ^{1
,

2} ; Lei GAO ^{1
,

2} ; Huiying QIU ^{1
,

2} ; Yuesheng ZHANG ^{1
,

2} ; Gusheng TANG ^{1
,

2} ; Jie CHEN ^{1
,

2} ; Weiping ZHANG ^{1
,

2} ; Jianmin WANG ^{1
,

2} ; Jianmin YANG ^{1
,

2} ; Xiaoxia HU ^{1
,

2}
Author Information

1. Department of Hematology, Changhai Hospital, the Naval Medical University
2. Institute of Hematologic Disease of Chinese PLA, Shanghai 200433, China
Publication Type:Journal Article
Keywords: Leukemia, myeloid, acute; Minimal residual disease; Consolidation chemotherapy; Allogeneic hematopoietic stem cell transplantation; Prognosis
From: Chinese Journal of Hematology 2020;41(1):16-22
CountryChina
Language:Chinese
Abstract: Objective:To probe the prognostic value of consolidation chemotherapy in non-favorable acute myeloid leukemia (AML) patients who were candidates for allogeneic hematopoietic stem cell transplantation (allo-HSCT) with first complete remission (CR₁) and negative minimal residual disease (MRD^-) .
Methods:A retrospective analysis was conducted on 155 patients with non-favorable AML who received allo-HSCT in CR₁/MRD^- from January 2010 to March 2019. The survival data were compared between patients who received and those not received pre-transplant consolidation chemotherapy.
Results:A total of 102 patients received pre-transplant consolidation chemotherapy (consolidation group) , and 53 cases directly proceeded to allo-HSCT when CR₁/MRD^- was achieved (nonconsolidation group) . The median ages were 39 (18-56) years old and 38 (19-67) years old, respectively. Five-year post-transplant overall survival [ (59.3±7.5) % vs (62.2±6.9) %, P=0.919] and relapse-free survival [ (53.0±8.9) % vs (61.6±7.0) %, P=0.936] were not significantly different between the two groups (consolidation vs nonconsolidation) . There was a weak relationship between consolidation therapy and cumulative incidence of relapse [consolidation: (21.9±5.4) % vs nonconsolidation: (18.3±6.0) %, P=0.942], as well as non-relapse mortality [consolidation: (22.4±4.3) % vs nonconsolidation: (28.4±6.5) %,P=0.464]. Multivariate analysis indicated that pre-transplant consolidation and the consolidation courses (< 2 vs ≥2 courses) did not have an impact on allo-HSCT outcomes.
Conclusion:Allo-HSCT for candidate patients without further consolidation when CR₁/MRD^- was attained was feasible.