Comparison of autologous hematopoietic cell transplantation, matched sibling donor hematopoietic cell transplantation, and chemotherapy in patients with favorable- and intermediate-risk acute myeloid leukemia
IntroductionHematopoietic stem cell transplantation (HSCT) and chemotherapy are considered potentially curative options for post-remission therapy in acute myeloid leukemia (AML). However, the comparative effectiveness of these approaches in favorable- and intermediate-risk AML remains unclear and r...
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Frontiers Media S.A.
2025-01-01
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| author | Mingyang Wang Shulian Chen Qiuqiu Zhang Linyu Yuan Xue Wang Junshi Zhang Xiaoyu Zhang Yigeng Cao Dongmei Li Xinxiao Lu Meijiao Wang Xiaosi Jiang Rongli Zhang Xin Chen Qiaoling Ma Jialin Wei Donglin Yang Yi He Aiming Pang Sizhou Feng Mingzhe Han Weihua Zhai Xingli Zhao Erlie Jiang |
| author_facet | Mingyang Wang Shulian Chen Qiuqiu Zhang Linyu Yuan Xue Wang Junshi Zhang Xiaoyu Zhang Yigeng Cao Dongmei Li Xinxiao Lu Meijiao Wang Xiaosi Jiang Rongli Zhang Xin Chen Qiaoling Ma Jialin Wei Donglin Yang Yi He Aiming Pang Sizhou Feng Mingzhe Han Weihua Zhai Xingli Zhao Erlie Jiang |
| author_sort | Mingyang Wang |
| collection | DOAJ |
| description | IntroductionHematopoietic stem cell transplantation (HSCT) and chemotherapy are considered potentially curative options for post-remission therapy in acute myeloid leukemia (AML). However, the comparative effectiveness of these approaches in favorable- and intermediate-risk AML remains unclear and requires further investigation.MethodsIn this retrospective study, 111 patients diagnosed with de novo favorable- and intermediate-risk AML, categorized according to the ELN 2022 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.ResultsIn the overall population, the 3-year overall survival (OS) rates were 85.7%, 83.1%, and 70.4% (p = 0.043), while the disease-free survival (DFS) rates were 78.6%, 83.2%, and 57.1% (p = 0.002) in the auto-HSCT, MSD-HSCT, and chemotherapy groups, respectively. Notably, both auto-HSCT and MSD-HSCT demonstrated significantly improved DFS compared to chemotherapy in patients with favorable-risk AML. Multivariate analysis further revealed 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).DiscussionThe 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. Further research is needed to support these conclusions. |
| format | Article |
| id | doaj-art-71bdbce639834be5ad54f81e6109bd9c |
| institution | Kabale University |
| issn | 1664-3224 |
| language | English |
| publishDate | 2025-01-01 |
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| series | Frontiers in Immunology |
| spelling | doaj-art-71bdbce639834be5ad54f81e6109bd9c2025-01-08T06:12:15ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-01-011510.3389/fimmu.2024.15110571511057Comparison of autologous hematopoietic cell transplantation, matched sibling donor hematopoietic cell transplantation, and chemotherapy in patients with favorable- and intermediate-risk acute myeloid leukemiaMingyang Wang0Shulian Chen1Qiuqiu Zhang2Linyu Yuan3Xue Wang4Junshi Zhang5Xiaoyu Zhang6Yigeng Cao7Dongmei Li8Xinxiao Lu9Meijiao Wang10Xiaosi Jiang11Rongli Zhang12Xin Chen13Qiaoling Ma14Jialin Wei15Donglin Yang16Yi He17Aiming Pang18Sizhou Feng19Mingzhe Han20Weihua Zhai21Xingli Zhao22Erlie Jiang23State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, ChinaDepartment of Hematology, Oncology Center, Tianjin Union Medical Center of Nankai University, Tianjin, ChinaDepartment of Hematology, Oncology Center, Tianjin Union Medical Center of Nankai University, Tianjin, ChinaDepartment of Hematology, Oncology Center, Tianjin Union Medical Center of Nankai University, Tianjin, ChinaDepartment of Hematology, Oncology Center, Tianjin Union Medical Center of Nankai University, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, ChinaCollege of Pharmacy, Nankai University, Tianjin, ChinaDepartment of Hematology, Oncology Center, Tianjin Union Medical Center of Nankai University, Tianjin, ChinaDepartment of Hematology, Oncology Center, Tianjin Union Medical Center of Nankai University, Tianjin, ChinaDepartment of Hematology, Oncology Center, Tianjin Union Medical Center of Nankai University, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, ChinaDepartment of Hematology, Oncology Center, Tianjin Union Medical Center of Nankai University, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, ChinaIntroductionHematopoietic stem cell transplantation (HSCT) and chemotherapy are considered potentially curative options for post-remission therapy in acute myeloid leukemia (AML). However, the comparative effectiveness of these approaches in favorable- and intermediate-risk AML remains unclear and requires further investigation.MethodsIn this retrospective study, 111 patients diagnosed with de novo favorable- and intermediate-risk AML, categorized according to the ELN 2022 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.ResultsIn the overall population, the 3-year overall survival (OS) rates were 85.7%, 83.1%, and 70.4% (p = 0.043), while the disease-free survival (DFS) rates were 78.6%, 83.2%, and 57.1% (p = 0.002) in the auto-HSCT, MSD-HSCT, and chemotherapy groups, respectively. Notably, both auto-HSCT and MSD-HSCT demonstrated significantly improved DFS compared to chemotherapy in patients with favorable-risk AML. Multivariate analysis further revealed 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).DiscussionThe 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. Further research is needed to support these conclusions.https://www.frontiersin.org/articles/10.3389/fimmu.2024.1511057/fullacute myeloid leukemiafavorable- and intermediate-riskhematopoietic stem cell transplantationchemotherapypost-remission treatment |
| spellingShingle | Mingyang Wang Shulian Chen Qiuqiu Zhang Linyu Yuan Xue Wang Junshi Zhang Xiaoyu Zhang Yigeng Cao Dongmei Li Xinxiao Lu Meijiao Wang Xiaosi Jiang Rongli Zhang Xin Chen Qiaoling Ma Jialin Wei Donglin Yang Yi He Aiming Pang Sizhou Feng Mingzhe Han Weihua Zhai Xingli Zhao Erlie Jiang Comparison of autologous hematopoietic cell transplantation, matched sibling donor hematopoietic cell transplantation, and chemotherapy in patients with favorable- and intermediate-risk acute myeloid leukemia Frontiers in Immunology acute myeloid leukemia favorable- and intermediate-risk hematopoietic stem cell transplantation chemotherapy post-remission treatment |
| title | Comparison of autologous hematopoietic cell transplantation, matched sibling donor hematopoietic cell transplantation, and chemotherapy in patients with favorable- and intermediate-risk acute myeloid leukemia |
| title_full | Comparison of autologous hematopoietic cell transplantation, matched sibling donor hematopoietic cell transplantation, and chemotherapy in patients with favorable- and intermediate-risk acute myeloid leukemia |
| title_fullStr | Comparison of autologous hematopoietic cell transplantation, matched sibling donor hematopoietic cell transplantation, and chemotherapy in patients with favorable- and intermediate-risk acute myeloid leukemia |
| title_full_unstemmed | Comparison of autologous hematopoietic cell transplantation, matched sibling donor hematopoietic cell transplantation, and chemotherapy in patients with favorable- and intermediate-risk acute myeloid leukemia |
| title_short | Comparison of autologous hematopoietic cell transplantation, matched sibling donor hematopoietic cell transplantation, and chemotherapy in patients with favorable- and intermediate-risk acute myeloid leukemia |
| title_sort | comparison of autologous hematopoietic cell transplantation matched sibling donor hematopoietic cell transplantation and chemotherapy in patients with favorable and intermediate risk acute myeloid leukemia |
| topic | acute myeloid leukemia favorable- and intermediate-risk hematopoietic stem cell transplantation chemotherapy post-remission treatment |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2024.1511057/full |
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