A long-term follow-up analysis in adult acute myeloid leukemia patients after hematopoietic stem cell transplantation

AIMS AND BACKGROUND: Over the last 17 years, 119 adult acute myeloid leukemia patients have undergone hematopoietic stem cell transplantation at our Center. STUDY DESIGN: Seventy patients in first complete remission received hematopoietic stem cell transplantation (28 allogeneic and 42 autologous HSCT) as late intensification after conventional chemotherapy; 38 patients received allogeneic hematopoietic stem cell transplantation in a more advanced phase. A reference group was built up by collecting 40 acute myeloid leukemia patients who received high-dose cytosine arabinoside as late intensification and whose complete remission lasted more than 10 months. RESULTS: Results of the study led to conclude that an earlier timing of allogeneic hematopoietic stem cell transplantation can be recommended in order to treat patients who would otherwise suffer an early relapse. CONCLUSIONS: The outcome of autologous hematopoietic stem cell transplantation in patients not in first complete remission supports the possibility of achieving good quality second complete remissions and suggests that autografting may be a life-saving strategy in selected acute myeloid leukemia patients with advanced disease.