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- Title
Impact of Consolidation Cycles Before Allogeneic Hematopoietic Cell Transplantation for Acute Myeloid Leukemia in First Complete Remission.
- Authors
Lee, Yoo Jin; Baek, Dong Won; Ahn, Jae-Sook; Ahn, Seo-Yeon; Jung, Sung-Hoon; Yang, Deok-Hwan; Lee, Je-Jung; Kim, Hyeoung Joon; Ham, Ji Yeon; Suh, Jang Soo; Sohn, Sang Kyun; Moon, Joon Ho
- Abstract
<bold>Background: </bold>The optimal number of high-dose cytarabine (HDAC) consolidation cycles before allogeneic hematopoietic cell transplantation (HCT) for acute myeloid leukemia is not fully standardized.<bold>Patients and Methods: </bold>This study evaluated the impact of HDAC consolidation cycles before allogeneic HCT in 194 patients with acute myeloid leukemia in first complete remission between 1998 and 2014. The patients were reclassified into 3 groups-no consolidation (C0, n = 20), 1 consolidation (C1, n = 115), and ≥ 2 consolidations (C2, n = 59)-by pre-HCT consolidation cycle.<bold>Results: </bold>The 3-year relapse-free survival rates was 45.9%, 66.9%, and 73.3% for the C0, C1, and C2 groups, respectively (P = .064), while the 3-year overall survival rates were 35.0%, 55.2%, and 67.5%, respectively (P = .106). The cumulative incidence of acute graft-versus-host disease (GVHD) was higher in the C2 group (38.7%) than in the C0 (22.2%) or C1 (17.7%) group (P = .018). However, the incidence of chronic GVHD showed no difference between the groups. Multivariate analysis for overall survival revealed the following independent factors: adverse cytogenetic risk (hazard ratio [HR] = 1.84, P = .046), C2 versus C0 (HR = 0.41, P = .037), pre-HCT status beyond CR1 versus CR1 (HR = 5.78, P < .001), and presence of chronic GVHD (HR = 0.45, P = .004).<bold>Conclusion: </bold>One or two cycles of HDAC consolidation therapy led to better subsequent HCT outcomes compared to the no-consolidation therapy group.
- Publication
Clinical Lymphoma, Myeloma & Leukemia, 2018, Vol 18, Issue 12, pe529
- ISSN
2152-2650
- Publication type
journal article
- DOI
10.1016/j.clml.2018.08.010