Long-term benefits of autologous stem cell transplantation versus intensive chemotherapy consolidation for acute myeloid leukemia patients: A propensity score matching analysis from the PETHEMA AML registry

Fecha de publicación:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Alfonso-Pierola A.
  • Martinez-Cuadrón D.
  • Gil C.
  • Martínez-Sánchez P.
  • Bernal T.
  • Benavente C.
  • Romero-Riquelme M.A.
  • Serrano-Lopez J.
  • Bergua J.M.
  • García-Boyero R.
  • Tormo M.
  • Herrera P.
  • Sossa-Melo C.L.
  • Pérez-Simon J.A.
  • Rodríguez-Medina C.
  • Bass-Maturana M.F.
  • López-Lorenzo J.L.
  • Algarra-Algarra L.
  • Vidriales-Vicente B.
  • Pérez-Encinas M.
  • Barrios-García M.
  • Vives S.
  • Sayas-Lloris M.J.
  • Capurro M.
  • Hidalgo S.
  • Olave M.
  • Cuervo-Lozada D.
  • Lavilla-Rubira E.
  • Casado F.
  • Mena-Durán A.
  • Valero-Nuñez M.
  • Casado-Calderón S.
  • Balerdi A.
  • Torres V.
  • Fernández R.
  • Noriega V.
  • Stevenazzi M.
  • Labrador J.
  • León-Maldonado P.
  • de Rueda-Ciller B.
  • Arce-Fernández O.
  • Amigo M.L.
  • Raposo-Puglia J.Á.
  • Solé M.
  • Ayala R.

Grupos

Abstract

While allogeneic stem cell transplantation (allo-SCT) is the preferred consolidation for high and most intermediate-risk acute myeloid leukemia (AML) patients in first remission, the role of autologous SCT (auto-SCT) vs. chemotherapy (CT) when allo-SCT is not feasible or indicated, remains controversial. We conducted a real-world, retrospective cohort study using the PETHEMA AML registry to compare auto-SCT and CT. Multivariate Cox regression and propensity score matching (PS-matching) were used to adjust for confounding factors. A total of 1272 patients in first remission and who received 2 consolidation courses were included (615 receiving additional CT cycles and 657 undergoing auto-SCT). Overall, 78.08% of auto-SCT patients were diagnosed before 2017, compared to 38.11% in the CT cohort (p < 0.001). In the overall cohort, auto-SCT was associated with significantly prolonged overall survival (OS) (HR: 0.73, p < 0.001) and relapse-free survival (RFS) (HR: 0.73, p < 0.001). This benefit was particularly evident in patients =65 years, those with normal karyotype, and FLT3-ITD negativity. In the PS-matched cohort, the RFS advantage persisted (HR: 0.80, p = 0.092), but OS differences were not statistically significant (HR: 0.91, p = 0.563). The role of auto-SCT in the genomic and targeted agent era should not be discarded. © The Author(s) 2025.

Datos de la publicación

ISSN/ISSNe:
0887-6924, 1476-5551

LEUKEMIA  SPRINGERNATURE

Tipo:
Article
Páginas:
2686-2696
PubMed:
40890512
Enlace a otro recurso:
www.scopus.com
Factor de Impacto:
4,030 SCImago ℠
Cuartil:
Q1 SCImago ℠

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Keywords

  • Adolescent; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Consolidation Chemotherapy; Female; Follow-Up Studies; Hematopoietic Stem Cell Transplantation; Humans; Leukemia, Myeloid, Acute; Male; Middle Aged; Prognosis; Propensity Score; Registries; Retrospective Studies; Survival Rate; Transplantation, Autologous; Young Adult; antineoplastic agent; acute myeloid leukemia; adult; aged; Article; autologous stem cell transplantation; chemotherapy; clinical outcome; cohort analysis; demographics; female; human; karyotype; major clinical study; male; middle aged; overall survival; propensity score; proportional hazards model; recurrence free survival; retrospective study; survival outcome; univariate analysis; adolescent; autotransplantation; comparative study; consolidation chemotherapy; follow up; hematopoietic stem cell transplantation; mortality; pathology; procedures; prognosis; propensity score; register; survival rate; therapy; young adult

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