Allogeneic Hematopoietic Stem Cell Transplantation from Sources other than Matched Related Donors in the Management of Elderly Acute Myeloid Leukemia Patients in First Complete Remission

Abstract

 The utility of allogeneic hematopoietic stem cell transplantation (allo-HSCT) from sources other than matched related donors (alternative donors) in the management of elderly acute myeloid leukemia (AML) patients in first complete remission (CR1) has not been clarified. To investigate the benefit of allo-HCST in the management of elderly AML patients in CR1, we retrospectively collected data from consecutive AML patients aged 60-66 years, who had been diagnosed between 2000 and 2014 and achieved CR. A total of 43 patients were included in this study, and 12 patients received allo-HSCT in CR1 only from alternative donors. Compared to chemotherapy alone, allo-HSCT improved overall survival (OS) (P=0.050) and cumulative incidence of relapse (CIR) (P=0.0059) in univariate analysis. OS and CIR at 3 years from CR1 were 82.5% vs 34.2%, and 17.5% vs 74.6%, respectively. In multivariate analysis, allo-HSCT also improved OS (hazard ratio (HR), 0.18; 95% confidence interval (CI), 0.039-0.80) and CIR (HR, 0.090; 95% CI, 0.029-0.28). Allo-HSCT from an alternative donor is a credible option in the treatment of elderly AML patients in CR1.