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Updated: May 4, 2026
Murine Model of Leukemia Relapse to Induction Chemotherapy for Acute Lymphoblastic Leukemia
Published on: October 17, 2025
Allogeneic transplantation versus chemotherapy as postremission therapy for acute myeloid leukemia: a prospective
Matthias Stelljes1, Utz Krug, Dietrich W Beelen
1Matthias Stelljes, Utz Krug, Maria C. Sauerland, Achim Heinecke, Sandra Ligges, Tim Sauer, Petra Tschanter, Gabriela B. Thoennissen, Björna Berning, Carsten Müller-Tidow, Wolfgang E. Berdel, and Thomas Büchner, University Hospital of Muenster, Muenster; Dietrich W. Beelen, University Hospital of Essen, Essen; Jan Braess, Krankenhaus Barmherzige Brüder; Albrecht Reichle, Ernst Holler, University of Regensburg, Regensburg; Hans J. Kolb, Wolfgang Hiddeman, University of Munich-Grosshadern, Munich; Rainer Schwerdtfeger, Deutsche Klinik für Diagnostik, Wiesbaden; Renate Arnold, Charité, Universitätsmedizin Berlin, Campus Virchow-Klinikum; Bernhard J. Woermann, German Society of Hematology and Oncology, Berlin; and Christoph Scheid, University of Cologne, Cologne, Germany.
Purpose:
The majority of patients with acute myeloid leukemia (AML) who achieve complete remission (CR) relapse with conventional postremission chemotherapy. Allogeneic stem-cell transplantation (alloSCT) might improve survival at the expense of increased toxicity. It remains unknown for which patients alloSCT is preferable.
Patients And Methods:
We compared the outcome of 185 matched pairs of a large multicenter clinical trial (AMLCG99). Patients younger than 60 years who underwent alloSCT in first remission (CR1) were matched to patients who received conventional postremission therapy. The main matching criteria were AML type, cytogenetic risk group, patient age, and time in first CR.
Results:
In the overall pairwise compared AML population, the projected 7-year overall survival (OS) rate was 58% for the alloSCT and 46% for the conventional postremission treatment group (P = .037; log-rank test). Relapse-free survival (RFS) was 52% in the alloSCT group compared with 33% in the control group (P < .001). OS was significantly better for alloSCT in patient subgroups with nonfavorable chromosomal aberrations, patients older than 45 years, and patients with secondary AML or high-risk myelodysplastic syndrome. For the entire patient cohort, postremission therapy was an independent factor for OS (hazard ratio, 0.66; 95% CI, 0.49 to 0.89 for alloSCT v conventional chemotherapy), among age, cytogenetics, and bone marrow blasts after the first induction cycle.
Conclusion:
AlloSCT is the most potent postremission therapy for AML and is particularly active for patients 45 to 59 years of age and/or those with high-risk cytogenetics.
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