Chezi Ganzel1, Jacob M Rowe1,2,3. 1. Department of Hematology, Shaare Zedek Medical Center, Jerusalem. 2. Department of Hematology and Bone Marrow Transplantation, Rambam Healthcare Campus. 3. Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.
Abstract
PURPOSE OF REVIEW: Autologous hematopoietic cell transplantation (auto-HCT) has been evaluated as a consolidation treatment for acute myeloid leukemia (AML) in the 1980s and 1990s. These prospective studies from large trials compared auto-HCT with chemotherapy. A comparison was made also with allogeneic hematopoietic cell transplantation (allo-HCT). These studies reported a lower relapse rate with auto-HCT compared with chemotherapy, but without impact on the overall survival. A high transplant-related mortality in that era confounded the relevance of these data. RECENT FINDINGS: Several prospective studies and a plethora of retrospective registry data have confirmed the potent antileukemic therapy of auto-HCT compared with chemotherapy and, in some instances, have even challenged the presumed superiority of allo-HCT as the definitive therapy for certain patients with AML. SUMMARY: The aggregate of recent data, prospective and retrospective, strongly suggests an important role for auto-HCT, at least as the most potent nonimmunologic antileukemia therapy. The transplant-related mortality in 2017 is close to that expected from standard consolidation therapy leading to the conclusion that the role of auto-HCT needs to be rigorously revisited, preferably in prospective studies, to establish its precise role in the current era.
PURPOSE OF REVIEW: Autologous hematopoietic cell transplantation (auto-HCT) has been evaluated as a consolidation treatment for acute myeloid leukemia (AML) in the 1980s and 1990s. These prospective studies from large trials compared auto-HCT with chemotherapy. A comparison was made also with allogeneic hematopoietic cell transplantation (allo-HCT). These studies reported a lower relapse rate with auto-HCT compared with chemotherapy, but without impact on the overall survival. A high transplant-related mortality in that era confounded the relevance of these data. RECENT FINDINGS: Several prospective studies and a plethora of retrospective registry data have confirmed the potent antileukemic therapy of auto-HCT compared with chemotherapy and, in some instances, have even challenged the presumed superiority of allo-HCT as the definitive therapy for certain patients with AML. SUMMARY: The aggregate of recent data, prospective and retrospective, strongly suggests an important role for auto-HCT, at least as the most potent nonimmunologic antileukemia therapy. The transplant-related mortality in 2017 is close to that expected from standard consolidation therapy leading to the conclusion that the role of auto-HCT needs to be rigorously revisited, preferably in prospective studies, to establish its precise role in the current era.
Authors: Katharina Kriegsmann; Petra Pavel; Tilmann Bochtler; Anita Schmitt; Sandra Sauer; Mark Kriegsmann; Thomas Bruckner; Stefan Klein; Harald Klüter; Carsten Müller-Tidow; Patrick Wuchter Journal: Transfus Med Hemother Date: 2020-09-15 Impact factor: 3.747
Authors: J F Yao; G X Zhang; D L Yang; Y He; J L Wei; W H Zhai; E L Jiang; R L Zhang; S Z Feng; M Z Han Journal: Zhonghua Xue Ye Xue Za Zhi Date: 2020-05-14