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ORIGINAL RESEARCH article
Front. Immunol.
Sec. Alloimmunity and Transplantation
Volume 15 - 2024 |
doi: 10.3389/fimmu.2024.1511057
Comparison of autologous hematopoietic cell transplantation, matched sibling donor hematopoietic cell transplantation, and chemotherapy in patients with favorable-and intermediate-risk acute myeloid leukemia
Provisionally accepted
Ming-Yang Wang
1
Shulian Chen
1
Qiu-Qiu Zhang
2*
Lin-Yu Yuan
2*
Xue Wang
2*
Jun-Shi Zhang
2*
Xiaoyu Zhang
1
Yi-Geng Cao
1
Xin-Xiao Lu
2*
Mei-Jiao Wang
2*
Xiao-Si Jiang
2*
Rong- Li Zhang
1*
Xin Chen
1*
Qiao-Ling Ma
1*
Jia-Lin Wei
1*
Donglin Yang
1
Yi He
1
Aiming Pang
1
Sizhou Feng
1
Mingzhe Han
1
Wei-Hua Zhai
1*
Xing-Li Zhao
2*
Erlie Jiang
1*- 1 National Clinical Research Center for Hematological Diseases, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
- 2 Department of Hematology, Oncology Center, Tianjin Union Medical Center of Nankai University., tianjin, China
The recommended treatment options therapeutic approaches for acute myeloid leukemia (AML) after remission are hematopoietic stem cell transplantation (HSCT) and chemotherapy. In this retrospective study, 111 patients diagnosed with de novo favorable-and intermediate-risk AML, categorized according to the ELN 2022 criteria guidelines, were investigated to compare outcomes following autologous HSCT (auto-HSCT), matched sibling donor HSCT (MSD-HSCT), and chemotherapy. Through propensity score matching for disease status before HSCT, 42 cases in first complete remission were selected for each of the auto-HSCT group and the MSD-HSCT group.Additionally, 27 cases in the chemotherapy group, excluding patients with early relapse or death, were included for comparison. The results revealed that in the overall population, the 3-year overall survival (OS) rates were 85.7%, 83.1%, and 70.4% in the auto-HSCT, MSD-HSCT, and chemotherapy groups, respectively (P=0.043). The 3-year disease-free survival (DFS) rates were 78.6%, 83.2%, and 57.1% respectively (P=0.002). Notably, both auto-HSCT and MSD-HSCT exhibited demonstrated significantly better DFS compared to chemotherapy in patients with favorable-risk AML. Multivariate analysis indicated that chemotherapy was significantly associated with inferior DFS compared to auto-HSCT (HR=2.82; 95% CI, 1.26-6.32, P=0.012), while DFS was similar between the MSD-HSCT and auto-HSCT groups (HR=0.80; 95% CI, 0.31-2.09, P=0.645). Overall, the findings suggested the advantages of both MSD-HSCT and auto-HSCT over chemotherapy as post-remission therapy for AML patients with favorable-and intermediate-risk.
Keywords: Acute Myeloid Leukemia, favorable-and intermediate-risk, Hematopoietic Stem Cell Transplantation, chemotherapy, Post-remission treatment
Received: 14 Oct 2024; Accepted: 10 Dec 2024.
Copyright: © 2024 Wang, Chen, Zhang, Yuan, Wang, Zhang, Zhang, Cao, Lu, Wang, Jiang, Zhang, Chen, Ma, Wei, Yang, He, Pang, Feng, Han, Zhai, Zhao and Jiang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Qiu-Qiu Zhang, Department of Hematology, Oncology Center, Tianjin Union Medical Center of Nankai University., tianjin, China
Lin-Yu Yuan, Department of Hematology, Oncology Center, Tianjin Union Medical Center of Nankai University., tianjin, China
Xue Wang, Department of Hematology, Oncology Center, Tianjin Union Medical Center of Nankai University., tianjin, China
Jun-Shi Zhang, Department of Hematology, Oncology Center, Tianjin Union Medical Center of Nankai University., tianjin, China
Xin-Xiao Lu, Department of Hematology, Oncology Center, Tianjin Union Medical Center of Nankai University., tianjin, China
Mei-Jiao Wang, Department of Hematology, Oncology Center, Tianjin Union Medical Center of Nankai University., tianjin, China
Xiao-Si Jiang, Department of Hematology, Oncology Center, Tianjin Union Medical Center of Nankai University., tianjin, China
Rong- Li Zhang, National Clinical Research Center for Hematological Diseases, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
Xin Chen, National Clinical Research Center for Hematological Diseases, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
Qiao-Ling Ma, National Clinical Research Center for Hematological Diseases, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
Jia-Lin Wei, National Clinical Research Center for Hematological Diseases, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
Wei-Hua Zhai, National Clinical Research Center for Hematological Diseases, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
Xing-Li Zhao, Department of Hematology, Oncology Center, Tianjin Union Medical Center of Nankai University., tianjin, China
Erlie Jiang, National Clinical Research Center for Hematological Diseases, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
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