Survival Analysis Of Hematopoietic Stem Cell Transplantation In Patients With Refractory Or Relapse Acute Myeloid Leukemia

Objective: To retrospectively analyze the survival of hematopoietic stem cell transplantation in patients with refractory or relapse acute myeloid leukemia during the past 10 years,and further to explore the independent prognostic factor.Methods: From January 1,2006 to July 1,2016,22 cases of refractory/ relapse AML who received HSCT were admitted in the center.Clinical data,including their age,gender,type of transplantation,acute or chronic GVHD(a GVHD or c GVHD),times of induction therapy,the first time's WBC,choice of pretreatment(MAC/RIC),presence of complications and so on,were collected.Then Kaplan-meier was used to analyse their overall survival(OS),and all factors' influence on patients' 2-year OS rate.Furthermore,cox regression model was performed to explore the independent prognostic factor after a single-factor analysis.Results: Following up to July 1,2017,there were 22 patients with refractory or relapse acute myeloid leukemia underwent HSCT in the center during the past 10 years.The 1-and 2-year OS rates are 45.5 % and 31.8 %,respectively.The average survival time is 23.1 months and the median survival time is 12.0 months.Lung infection is the major cause of death in these patients,following by relapse and a GVHD.Cox proportional-hazards model suggests that times of induction therapy,a GVHD,and WBC are the independent prognostic factor for the patients with refractory or relapse acute myeloid leukemia after HSCT(P=0.001,P=0.002,P= 0.001).Conclusions: In our center,HSCT is an ideal treatment method for refractory/relapsed AML patients,and its major cause of death is lung infection.In these patients,times of induction therapy,a GVHD,and WBC are the independent prognostic factor for the patients with refractory or relapse acute myeloid leukemia after HSCT.