Josefina Serrano, David Martínez-Cuadrón, Cristina Gil, Teresa Bernal, Mar Tormo, Pilar Martínez-Sánchez, Carlos Rodríguez-Medina, Pilar Herrera, José A Pérez Simón, María J Sayas, Juan Bergua, Esperanza Lavilla-Rubira, Mariluz Amigo, Celina Benavente, José L López Lorenzo, Manuel M Pérez-Encinas, María B Vidriales, Clara Aparicio-Pérez, Esther Prados de la Torres, Mercedes Colorado, Beatriz de Rueda, Raimundo García-Boyero, Sandra Marini, Julio García-Suárez, María López-Pavía, María I Gómez-Roncero, Víctor Noriega, Aurelio López, Jorge Labrador, Ana Cabello, Claudia Sossa, Lorenzo Algarra, Mariana Stevenazzi, Laura Torres, Blanca Boluda, Joaquín Sánchez-Garcia, Pau Montesinos
{"title":"Autologous or allogeneic hematopoietic stem cell transplantation as front-line treatment for adult secondary acute myeloid leukemia patients: the PETHEMA registry experience.","authors":"Josefina Serrano, David Martínez-Cuadrón, Cristina Gil, Teresa Bernal, Mar Tormo, Pilar Martínez-Sánchez, Carlos Rodríguez-Medina, Pilar Herrera, José A Pérez Simón, María J Sayas, Juan Bergua, Esperanza Lavilla-Rubira, Mariluz Amigo, Celina Benavente, José L López Lorenzo, Manuel M Pérez-Encinas, María B Vidriales, Clara Aparicio-Pérez, Esther Prados de la Torres, Mercedes Colorado, Beatriz de Rueda, Raimundo García-Boyero, Sandra Marini, Julio García-Suárez, María López-Pavía, María I Gómez-Roncero, Víctor Noriega, Aurelio López, Jorge Labrador, Ana Cabello, Claudia Sossa, Lorenzo Algarra, Mariana Stevenazzi, Laura Torres, Blanca Boluda, Joaquín Sánchez-Garcia, Pau Montesinos","doi":"10.1016/j.jtct.2025.02.011","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>It is widely accepted that allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the only potentially curative option available for secondary Acute Myeloid Leukemia (sAML). However, clinical factors impacting outcomes after allo-HSCT and the potential role of autologous-HSCT (auto-HSCT) in real-life series are needed. Previously, the PETHEMA group reported a series of 2310 patients with sAML within the nationwide registry. Out of them, 876 were candidates to receive chemotherapy and 274 patients (55 auto-HSCT and 219 allo-HSCT).</p><p><strong>Objective: </strong>In this work, we have analyzed the role auto-HSCT (N=55) or allo-HSCT (N=219) as front-line treatment for sAML patients included in AML Spanish PETHEMA registry. In this paper, we analyze outcomes as well as prognostic variables in this series of patients undergoing auto- or allo-HSCT as part of the front-line treatment for sAML.</p><p><strong>Study design: </strong>We used the multinational PETHEMA AML registry (NCT02607059) to identify adult patients (age ≥18 years) with a diagnosis of sAML who received auto- or allo-HSCT as front-line treatment in Spanish and Portuguese institutions from August, 1<sup>st</sup> 1992 until July, 31<sup>st</sup> 2020). Patient characteristics, diagnostic findings, and management, including treatments, characteristics of HSCT and outcomes, were retrieved from the PETHEMA AML registry in this retrospective multicenter analysis.</p><p><strong>Results: </strong>With a median follow-up of 32.7 months, better 5-year OS and LFS were obtained with allo-HSCT in CR1 (44.5% and 39.9%, respectively), as compared with auto-HSCT in CR1 (30% and 20.5%, respectively) but without reaching statistical differences for OS (p= 0.22 and p=0.03). The higher incidence of relapse in auto-HSCT is counterbalanced with the significantly low NRM rate. For allo-HSCT patients, 5-year outcomes were significantly influenced by the cytogenetic/genetic risk. In multivariate analysis, adverse cytogenetic/genetic risk group retained statistical significance for all endpoints.</p><p><strong>Conclusion: </strong>As conclusions, we confirmed the role of allo-HSCT as a potential curative option for patients and we report that auto-HSCT in CR can still provide a 5-year LFS of 20% in sAML patients. Finally, our results confirm adverse cytogenetic/genetic risk category as an independent negative factor in sAML patients receiving HSCT.</p>","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":" ","pages":""},"PeriodicalIF":3.6000,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Transplantation and Cellular Therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jtct.2025.02.011","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEMATOLOGY","Score":null,"Total":0}
Autologous or allogeneic hematopoietic stem cell transplantation as front-line treatment for adult secondary acute myeloid leukemia patients: the PETHEMA registry experience.
Background: It is widely accepted that allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the only potentially curative option available for secondary Acute Myeloid Leukemia (sAML). However, clinical factors impacting outcomes after allo-HSCT and the potential role of autologous-HSCT (auto-HSCT) in real-life series are needed. Previously, the PETHEMA group reported a series of 2310 patients with sAML within the nationwide registry. Out of them, 876 were candidates to receive chemotherapy and 274 patients (55 auto-HSCT and 219 allo-HSCT).
Objective: In this work, we have analyzed the role auto-HSCT (N=55) or allo-HSCT (N=219) as front-line treatment for sAML patients included in AML Spanish PETHEMA registry. In this paper, we analyze outcomes as well as prognostic variables in this series of patients undergoing auto- or allo-HSCT as part of the front-line treatment for sAML.
Study design: We used the multinational PETHEMA AML registry (NCT02607059) to identify adult patients (age ≥18 years) with a diagnosis of sAML who received auto- or allo-HSCT as front-line treatment in Spanish and Portuguese institutions from August, 1st 1992 until July, 31st 2020). Patient characteristics, diagnostic findings, and management, including treatments, characteristics of HSCT and outcomes, were retrieved from the PETHEMA AML registry in this retrospective multicenter analysis.
Results: With a median follow-up of 32.7 months, better 5-year OS and LFS were obtained with allo-HSCT in CR1 (44.5% and 39.9%, respectively), as compared with auto-HSCT in CR1 (30% and 20.5%, respectively) but without reaching statistical differences for OS (p= 0.22 and p=0.03). The higher incidence of relapse in auto-HSCT is counterbalanced with the significantly low NRM rate. For allo-HSCT patients, 5-year outcomes were significantly influenced by the cytogenetic/genetic risk. In multivariate analysis, adverse cytogenetic/genetic risk group retained statistical significance for all endpoints.
Conclusion: As conclusions, we confirmed the role of allo-HSCT as a potential curative option for patients and we report that auto-HSCT in CR can still provide a 5-year LFS of 20% in sAML patients. Finally, our results confirm adverse cytogenetic/genetic risk category as an independent negative factor in sAML patients receiving HSCT.
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