[Clinical Analysis for Patients with AML Treated after Allo-HSCT]

Area of Science:

• Hematology
• Oncology
• Transplantation Medicine

Background:

• Acute myeloid leukemia (AML) survival has improved with allogeneic hematopoietic stem cell transplantation (allo-HSCT).
• Relapse remains a significant factor impacting long-term survival in AML patients post-allo-HSCT.
• Identifying risk factors and effective salvage therapies for relapsed AML is crucial.

Purpose of the Study:

• To identify risk factors influencing survival and relapse in AML patients undergoing allo-HSCT.
• To investigate therapeutic strategies for managing AML relapse after allo-HSCT.

Main Methods:

• Retrospective analysis of clinical data from 180 AML patients who achieved complete remission before allo-HSCT.
• COX regression analysis was employed to determine risk factors for survival and relapse.

Main Results:

• The 5-year overall survival (OS), event-free survival (EFS), and cumulative relapse rates were 74.3%, 42.5%, and 25.0%, respectively.
• Independent risk factors for OS included high-risk status, adverse cytogenetics, CR2 at HSCT, and absence of cGvHD.
• High-risk status, MRD positivity, adverse cytogenetics, and absence of cGVHD were associated with relapse; hypomethylation agents plus DLI improved OS in relapsed patients (2-year OS 62.5%).

Conclusions:

• Allo-HSCT significantly enhances AML survival, yet relapse remains a primary determinant of patient outcomes.
• Maintenance therapy combining hypomethylation agents with donor lymphocyte infusion (DLI) presents a potential effective treatment for relapsed AML post-allo-HSCT.