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Ghavamzadeh. A, Ali Moghaddam. K, Vaezi. M, Zafari. Y, Maheriazar. R, Mousavi.A, Bahar.B, Jahani.M
Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences
Objectives: To assess the effects of additional consolidation therapy in acute myeloid leukemia (AML) patients before allogeneic hematopoietic stem cell transplantation (HSCT).
Methods: Seventy-two AML patients (range: 18- 55 years) who transplanted in CR1 after being treated with a standard chemotherapy (7+3) regimen were randomly divided into two groups. Thirty-six patients in group A directly underwent transplantation and 36 in group B received chemotherapy regimen (5+2) prior to allogeneic HSCT. All patients received fully HLA-matched transplants.
Results: The median age at transplantation was 38.3 in group A and 37.2 in group B. The male to female ratio was 21:15 and 23:13 in groups A and B, respectively. The median time to neutrophil and platelet recovery was 8 and 27 days in group A, while it was 9 and 19 days in group B, respectively (P: 0.77, 0.01). Acute graft- versus- host disease (GvHD) was more frequent in group A (26 versus. 23) patients(P:0.44). Chronic GvHD was more frequent in group A( 18 versus16) patients(P: 0.37). Five relapses were observed in group A and 9 relapses occurred in group B (P: 0.23). The main causes of death in both groups were relapse (50%) and aGvHD (22.2%). The median follow-up time was 24 months. Disease – free survival (DFS) was 47 in group A and 37 months (P: 0.34) in groups B. The study showed overall survival (OS) of 45 and 34 months (P: 0.71) in groups A and B, respectively.
Conclusion: Even without considering the costs of treatment, it is recommended that AML patients directly undergo transplantation after being treated with a standard chemotherapy regimen (7+3) because no differences in DFS, OS, GvHD were observed between the two groups.