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<p>Despite advancements in treatment, the prognosis for elderly AML patients remains poor. We conducted a retrospective study involving 307 consecutive AML patients, including 71 who underwent haploidentical hematopoietic cell transplantation (Haplo) and 236 who received chemotherapy (Chemo) only. Propensity score matching with 1:1 ratio was performed to balance the groups based on age at treatment initiation, gender, and European Leukemia Net (ELN) 2022 risk classification. 69 case-controlled pairs in the Haplo and Chemo group were analyzed after matching. The two groups were comparable concerning therapy prior to complete remission and 72.5% of patients in the Haplo group received reduced-intensity conditioning. Haplo was associated with a significant survival advantage over Chemo, with a 1-year OS of 77.9% (95% confidence interval(CI), 65.5–86.3, <i>p</i> = 0.001) versus 62.0% (95% CI, 47.9–73.2, <i>p</i> = 0.009). A significanly higher 1-year LFS of 74.1% (95% CI, 61.5–83.1) was also observed compared with 42.0% (95% CI, 29.3–54.0) in the chemotherapy group (<i>p</i> &lt; 0.0001). The survival advantage was majorly due to a significantly reduced relapse incidence (Haplo: 16.5% (95% CI, 8.7–26.5) vs Chemo: 56.6% (95% CI, 42.9–68.2)). The 1-year non-relapse mortality was 9.4% (95% CI, 3.8–18.2) in the Haplo group. To conclude, haploidentical HCT showed superior outcomes to chemotherapy alone and might be recommended to AML patients 55 years or older eligible for transplant in future practice.</p>

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Superior outcomes of haploidentical hematopoietic cell transplantation over chemotherapy in AML patients 55 years or older

  • 期刊论文

  • 发表日期：

    2025年3月30日

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  • Lin Li,
  • Lixia Zhu,
  • Mengqi Xiong,
  • Zhile Chen,
  • Yi Luo,
  • Jimin Shi,
  • Ting Chen,
  • Yanmin Zhao,
  • Jian Yu,
  • Xiaoyu Lai,
  • Lizhen Liu,
  • Huarui Fu,
  • Diange Jin,
  • Guanfang Zhang,
  • Shanshan Pei,
  • Yue Liang,
  • Xiujin Ye,
  • Yishan Ye,
  • Xi Zhang,
  • He Huang

摘要

Despite advancements in treatment, the prognosis for elderly AML patients remains poor. We conducted a retrospective study involving 307 consecutive AML patients, including 71 who underwent haploidentical hematopoietic cell transplantation (Haplo) and 236 who received chemotherapy (Chemo) only. Propensity score matching with 1:1 ratio was performed to balance the groups based on age at treatment initiation, gender, and European Leukemia Net (ELN) 2022 risk classification. 69 case-controlled pairs in the Haplo and Chemo group were analyzed after matching. The two groups were comparable concerning therapy prior to complete remission and 72.5% of patients in the Haplo group received reduced-intensity conditioning. Haplo was associated with a significant survival advantage over Chemo, with a 1-year OS of 77.9% (95% confidence interval(CI), 65.5–86.3, p = 0.001) versus 62.0% (95% CI, 47.9–73.2, p = 0.009). A significanly higher 1-year LFS of 74.1% (95% CI, 61.5–83.1) was also observed compared with 42.0% (95% CI, 29.3–54.0) in the chemotherapy group (p < 0.0001). The survival advantage was majorly due to a significantly reduced relapse incidence (Haplo: 16.5% (95% CI, 8.7–26.5) vs Chemo: 56.6% (95% CI, 42.9–68.2)). The 1-year non-relapse mortality was 9.4% (95% CI, 3.8–18.2) in the Haplo group. To conclude, haploidentical HCT showed superior outcomes to chemotherapy alone and might be recommended to AML patients 55 years or older eligible for transplant in future practice.