A Retrospective Analysis Of Prognosis In 107 Favorable-risk AML Patients With Different Consolidation Treatments

?Background?Currently,for adult favorable-risk acute myeloid leukemia(AML),Standard postremission strategies include conventionalchemotherapy as well as hematopoieticcelltransplantation.Specific treatments include the following:1.Chemotherapy regimens with high dose cytarabine(HD-Ara-C).2.Hematopoietic stem cell transplantation(HSCT),including allogeneic hematopoietic stem cell transplantation(allo-HSCT),autologous hematopoietic stem cell transplantation(auto-PBSCT)and microtransplantion.But at present there are not a sure strategy accepted at the international level after treatment for such patients.So we should explore the prognosis impact in favorable-risk acute myeloid leukemia(AML)patients with different consolidation treatment after first complete remission(CR).?Methods?A total of 107 cases of non-refractory adult AML from January 2010 to June 2015 in single-center were enrolled in the study.HD-Ara-C group(38 cases)as the control group,to explore the prognosis of different consolidation treatments[microtransplantation(16 cases),autologous transplantation(auto-PBSCT,14 cases),allogeneic transplantation(allo-HSCT,39 cases)] groups.?Results?Of 107 patients(59 males and 48 females),the median age is 33(16~59)years old,the median follow-up time is 36.5(5.3~79.1)months,overall relapse rate was 20.6%(22/107),and overall mortality ratewas 18.7%(20/107).The 5 years cumulative relapse rate(CIR)of HD-Ara-C,microtransplantation,auto-PBSCT and allo-HSCT group were 39.7%,6.2%,14.3% and 5.6%;with statistical significance(P=0.000).The CIR of the experiment group was lower than the HD-Ara-C group.The 5 years progression-free survival(PFS)rate of HD-Ara-C,microtransplantation,auto-PBSCT and allo-HSCT group were 44.7%,93.8%,85.7% and 78.1%;with statistical significance(P=0.011).The PFS of experiment group is similar,the PFS of HD-Ara-C group was inferior to other groups.The 5 year overall survival(OS)rate of four groups were 54.9%,100%,92.9% and 77.4%(P > 0.05).Multiple factors analysis showed that compare to the consolidation chemotherapy(HD-Ara-C),allo-HSCT can improve PFS(HR = 0.376,P = 0.031),but it can't improve the OS(P > 0.05);Microtransplantation and auto-PBSCT can not improve the PFS or OS(P > 0.05).?Conclusion?Compared with HD-Ara-C group,the allo-HSCT can obviously decreaseCIR,improve the PFS,but treatment-related mortalityis high,no survival benefit was seen in CR1.The result show that equal effect withAuto-PBSCT and microtransplantationcompared withHD-Ara-C chemotherapy,so both can be used as a option of consolidation treatment for favorable-risk AML.