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