First Complete Remission versus other- than- First Complete Remission in Acute Myelogenous Leukemia with Allogeneic Hematopoietic Stem Cell Transplantation

Abstract

Introduction: The traditional goal of the treatment of Acute Myelogenous Leukemia is to produce and maintain a complete remission (CR).The difference in survival time was entirely attributable to the duration of time spent in CR .In this study, the outcome of AML patients with allogeneic HSCT in CR1 versus other than CR1 was compared.
Patients and Methods: Since March 1991 until November 2008, from 420 AML patients, 312 patients in CR1 with a median age of 28 years and 108 patients in other- than- CR1 with a median age of 27 years, have undergone allogeneic HSCT. The male/female ratio was 168/144 in the CR1 group and 55/53 in other- than- CR1. In totals 391 patients received Peripheral Blood, 27 patients Bone Marrow and 2 patients, Cord Blood as sources of HSCT.
Results: At present, 266 (85%) patients in CR1 and 73 (68%) patients in other- than-CR1 are living. The most common cause of death in CR1 group was Graft Versus Host Disease and in the other- than CR1 group was relapse. Median follow up time was 17 months (range: 1-158 months). Six month Disease Free Survival (DFS) and Overall Survival (OS) in CR1 was 86% and 91% (SE=2%). 2-years DFS and OS in CR1 was 78% (SE=3%) and 85% (SE=2%). Six month DFS and OS in other- than- CR1 was 64% (SE=5%) and 75% (SE=4%). In this groups 2 years DFS and OS was 50% and 64% (SE=5%). It is to be noted that six month DFS and OS in transplanted patients with CR1 was significantly higher than in other- than- CR1 (p<0.001). Furthermore, 2-years DFS and OS in patients with CR1 were better than the second group (P< 0.001).
Conclusion: Although the results of HSCT in other than first complete remission is not as good as in first complete remission, it seems that it is good enough to advise doing allogeneic HSCT for these patients.