Long-term benefits of autologous stem cell transplantation versus intensive chemotherapy consolidation for acute myeloid leukemia patients: A propensity score matching analysis from the PETHEMA AML registry
Ana Alfonso-Pierola, David Martinez-Cuadrón, Rebeca Rodríguez-Veiga, Cristina Gil, Pilar Martínez-Sánchez, Teresa Bernal, Celina Benavente, Mónica A. Romero-Riquelme, Josefina Serrano-Lopez, Juan M. Bergua, Raimundo García-Boyero, Mar Tormo, Pilar Herrera, Claudia L. Sossa-Melo, José A. Pérez-Simon, Carlos Rodríguez-Medina, María F. Bass-Maturana, José L. López-Lorenzo, Lorenzo Algarra-Algarra, Belén Vidriales-Vicente, Manuel Pérez-Encinas, Manuel Barrios-García, Susana Vives, María J. Sayas-Lloris, Marisa Capurro, Sebastián Hidalgo, Mayte Olave, Diana Cuervo-Lozada, Esperanza Lavilla-Rubira, Felipe Casado, Armando Mena-Durán, Marta Valero-Nuñez, Soledad Casado-Calderón, Amaia Balerdi, Vivianne Torres, Rosa Fernández, Víctor Noriega, Mariana Stevenazzi, Jorge Labrador, Pilar León-Maldonado, Beatriz de Rueda-Ciller, Olga Arce-Fernández, María L. Amigo, José Ángel Raposo-Puglia, María Solé, Blanca Boluda, Rosa Ayala, Eva Barragán, Pau Montesinos
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引用次数: 0
Abstract
While allogeneic stem cell transplantation (allo-SCT) is the preferred consolidation for high and most intermediate-risk acute myeloid leukemia (AML) patients in first remission, the role of autologous SCT (auto-SCT) vs. chemotherapy (CT) when allo-SCT is not feasible or indicated, remains controversial. We conducted a real-world, retrospective cohort study using the PETHEMA AML registry to compare auto-SCT and CT. Multivariate Cox regression and propensity score matching (PS-matching) were used to adjust for confounding factors. A total of 1272 patients in first remission and who received 2 consolidation courses were included (615 receiving additional CT cycles and 657 undergoing auto-SCT). Overall, 78.08% of auto-SCT patients were diagnosed before 2017, compared to 38.11% in the CT cohort (p < 0.001). In the overall cohort, auto-SCT was associated with significantly prolonged overall survival (OS) (HR: 0.73, p < 0.001) and relapse-free survival (RFS) (HR: 0.73, p < 0.001). This benefit was particularly evident in patients ≤65 years, those with normal karyotype, and FLT3-ITD negativity. In the PS-matched cohort, the RFS advantage persisted (HR: 0.80, p = 0.092), but OS differences were not statistically significant (HR: 0.91, p = 0.563). The role of auto-SCT in the genomic and targeted agent era should not be discarded.
期刊介绍:
Title: Leukemia
Journal Overview:
Publishes high-quality, peer-reviewed research
Covers all aspects of research and treatment of leukemia and allied diseases
Includes studies of normal hemopoiesis due to comparative relevance
Topics of Interest:
Oncogenes
Growth factors
Stem cells
Leukemia genomics
Cell cycle
Signal transduction
Molecular targets for therapy
And more
Content Types:
Original research articles
Reviews
Letters
Correspondence
Comments elaborating on significant advances and covering topical issues