| Title | Efficacy of Allogeneic Hematopoietic Stem Cell Transplantation in Intermediate-Risk Acute Myeloid Leukemia Adult Patients in First Complete Remission: A Meta-Analysis of Prospective Studies |
| Authors | Li, Dandan Wang, Li Zhu, Honghu Dou, Liping Liu, Daihong Fu, Lin Ma, Cong Ma, Xuebin Yao, Yushi Zhou, Lei Wang, Qian Wang, Lijun Zhao, Yu Jing, Yu Wang, Lili Li, Yonghui Yu, Li |
| Affiliation | Chinese Peoples Liberat Army Gen Hosp, Dept Hematol, Beijing, Peoples R China. Med Coll Chinese PLA, Beijing, Peoples R China. Peking Univ, Inst Hematol, Peoples Hosp, Dept Hematol, Beijing 100871, Peoples R China. Peking Univ, Hosp 3, Dept Hematol, Beijing 100871, Peoples R China. PLA Navy Gen Hosp, Dept Clin Lab, Beijing, Peoples R China. PLA Navy Gen Hosp, Tumor Diag & Treatment Ctr, Beijing, Peoples R China. 202 Hosp PLA, Dept Hematol, Shenyang, Peoples R China. |
| Keywords | BONE-MARROW-TRANSPLANTATION ACUTE MYELOGENOUS LEUKEMIA HIGH-DOSE CYTARABINE PROSPECTIVE CONTROLLED-TRIAL PROSPECTIVE MULTICENTER TRIAL VERSUS-HOST-DISEASE POSTREMISSION THERAPY INTENSIFICATION CHEMOTHERAPY CONSOLIDATION CHEMOTHERAPY INTENSIVE CHEMOTHERAPY |
| Issue Date | 2015 |
| Publisher | PLOS ONE |
| Citation | PLOS ONE.2015,10,(7). |
| Abstract | Hematopoietic stem cell transplantation (HSCT) and consolidation chemotherapy have been used to treat intermediate-risk acute myeloid leukemia (AML) patients in first complete remission (CR1). However, it is still unclear which treatments are most effective for these patients. The aim of our study was to analyze the relapse-free survival (RFS) and overall survival (OS) benefit of allogeneic HSCT (alloHSCT) for intermediate-risk AML patients in CR1. A meta-analysis of prospective trials comparing alloHSCT to non-alloHSCT (autologous HSCT [autoHSCT] and/or chemotherapy) was undertaken. We systematically searched PubMed, Embase, and the Cochrane Library though October 2014, using keywords and relative MeSH or Emtree terms, 'allogeneic'; 'acut*' and 'leukem*/aml/leukaem*/ leucem*/leucaem*'; and 'nonlympho*' or 'myelo*'. A total of 7053 articles were accessed. The primary outcomes were RFS and OS, while the secondary outcomes were treatment-related mortality (TRM) and relapse rate (RR). Hazard ratios (HR) and 95% confidence intervals (CI) were calculated for each outcome. The primary outcomes were RFS and OS, while the secondary outcomes were TRM and RR. We included 9 prospective controlled studies including 1950 adult patients. Patients with intermediate-risk AML in CR1 who received either alloHSCT or non-alloHSCT were considered eligible. AlloHSCT was found to be associated with significantly better RFS, OS, and RR than non-alloHSCT (HR, 0.684 [95% CI: 0.48, 0.95]; HR, 0.76 [95% CI: 0.61, 0.95]; and HR, 0.58 [95% CI: 0.45, 0.75], respectively). TRM was significantly higher following alloHSCT than non-alloHSCT (HR, 3.09 [95% CI: 1.38, 6.92]). However, subgroup analysis showed no OS benefit for alloHSCT over autoHSCT (HR, 0.99 [95% CI: 0.70, 1.39]). In conclusion, alloHSCT is associated with more favorable RFS, OS, and RR benefits (but not TRM outcomes) than non-alloHSCT generally, but does not have an OS advantage over autoHSCT specifically, in patients with intermediate-risk AML in CR1. |
| URI | http://hdl.handle.net/20.500.11897/418178 |
| ISSN | 1932-6203 |
| DOI | 10.1371/journal.pone.0132620 |
| Indexed | SCI(E) PubMed |
| Appears in Collections: | 第三医院 |
