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Allogeneic Hematopoietic Stem Cell Transplantation for Therapy-Related AML

By: Joshua Swore
Posted: Wednesday, July 14, 2021

Allogeneic hematopoietic stem cell transplantation may improve the prognosis of therapy-related acute myeloid leukemia (AML) with mixed lineage leukemia (MLL) rearrangement, according to a retrospective study published in the American Journal of Cancer Research. However, according to study authors Yu Zhang, PhD, and colleagues from the Southern Medical University, China, a larger prospective cohort is needed to confirm these initial results.

Data from 150 patients with therapy-related AML (n = 41), therapy-related AML with MLL rearrangement (n = 18), and de novo AML with MML rearrangement (n = 98) were used for the analysis. Patients were treated with chemotherapy or a combination of chemotherapy and allogeneic hematopoietic stem cell transplantation.

The authors reported a median follow-up of 13 months, at which point 69 of the 150 patients were alive. The 3-year overall survival rate was highest among patients with therapy-related AML without MLL rearrangement at 37.5%, whereas patients with therapy-related AML and MLL rearrangement had an overall survival rate of 21.5%. Leukemia-free survival and the incidence of relapse were reported at 32.2% and 50.4% for patients with therapy-related AML and MLL rearrangement.

Patients who underwent chemotherapy alone for therapy-related AML and MLL rearrangement exhibited an overall survival rate of 17.9%, which was the highest among all groups. The overall survival rate for this group improved to 52.7% with allogeneic hematopoietic stem cell transplantation. Furthermore, the group reported improvements in the leukemia-free survival rate, 48.8%, and the relapse rate, 47.4%, after transplantation. The authors noted that a multivariate analysis revealed transplantation therapy-related AML with MLL rearrangement was no longer considered a risk factor for both relapse and decreased leukemia-free survival (P = .882 and P = .484).

Disclosure: The authors reported no conflicts of interest.


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