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Abstract
We retrospectively compared allogeneic hematopoietic stem cell transplantation (allo-HSCT) with chemotherapy as a post-remission therapy of adult patients with intermediate or poor risk acute myeloid leukemia (AML). We identified a cohort of patients aged 16 to 65 years diagnosed between 2014 and 2020 in 19 Argentinian centers. We compared relapse-free survival (RFS), overall survival (OS) and the cumulative incidence of relapse (CIR) at 3 years, in patients with AML in first CR treated with allo-HSCT vs chemoterapy as post-remission strategy and by subgroups: patients older or
younger than 50 years and cytogenetic risk group. Overall, 306 patients achieved a CR1. Of these, 118 patients (39%) underwent HSCT. In the entire patient cohort, allo-HSCT demonstrated superiority in terms of relapse free survival (adjusted HR: all patients, .49 (95% CI, .32-.75) and overall survival (adjusted HR: all patients, .53 (95% CI, .35-.85)); as well as a lower incidence of relapse (adjusted HR: all patients, .26 (95% CI, .15-.47)) versus consolidation with chemotherapy. The differences were significant in the multivariate analysis for OS, RFS and CIR in patients under 50 years of age and intermediate cytogenetic risk. In patients older than 50 years there is a non-significant trend in favor of transplantation, while in patients with poor risk, significant differences were found in favor of transplantation in the univariate analysis.
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