Journal of Medical Council of Iran
مجله علمی پژوهشی سازمان نظام پزشکی
Volume 42, Issue 3 (2024)
jmciri 2024, 42(3): 32-40 |
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Bahri T, Barkhordar M, Tavakoli S, Babakhani D, Azari M, Janbabai G, et al . Allogeneic Hematopoietic Stem Cell Transplantation Outcomes in Patients with Acute Myeloid Leukemia: A 30-Year Retrospective Study at a Referral Center. jmciri 2024; 42 (3) :32-40
URL: http://jmciri.ir/article-1-3329-en.html
URL: http://jmciri.ir/article-1-3329-en.html
Tanaz Bahri 
, Maryam Barkhordar , Sahar Tavakoli , Davood Babakhani , Mojtaba Azari , Ghasem Janbabai , Ardeshir Ghavamzadeh , Mohammad Vaezi
, Maryam Barkhordar , Sahar Tavakoli , Davood Babakhani , Mojtaba Azari , Ghasem Janbabai , Ardeshir Ghavamzadeh , Mohammad Vaezi
Cell Therapy and Stem Cell Transplantation Research Center of Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
Abstract: (713 Views)
Abstract
Background: Allogeneic hematopoietic stem cell transplantation (HSCT) is considered the only effective therapeutic option for eradicating acute myeloid leukemia (AML) after achieving remission. Evaluating treatment outcomes and addressing challenges at each center are essential for improving conditions and overcoming obstacles. Thus, this study aimed to evaluate the outcomes of HSCT in AML patients who had. undergone transplantation at our center over the past three decades.
Methods: This retrospective cohort study was conducted at the Oncology, Hematology, and Transplant Research Institute on adult AML patients who underwent allogeneic HSCT between January 1991 and January 2022. Data on demographic, clinical, and laboratory characteristics were collected from medical records. The primary objectives included evaluating overall 5-year overall survival (OS) and disease-free survival (DFS) across all patients, and comparing outcomes based on the timing of transplant and pre-transplant remission status. Secondary objectives included assessing non-relapse mortality (NRM) and relapse incidence (RI). Statistical analyses were conducted to compare outcomes between two groups: those who received transplants before 2010 (D1) and those who received transplants after 2010 (D2).
Results: In total, 1,337 AML patients were analyzed, with 477 in group D1 and 860 in group D2. The median follow-up duration was 111 months for D1 and 62 months for D2. OS was similar between the two groups (56.64% for D1 vs. 57.86% for D2), but OS improvements were observed only in patients who underwent transplantation in later remissions (CR2 and CR≥3) after 2010. DFS were also generally similar between the two groups, but significant improvements were noted for CR2 and CR≥3 patients transplanted after 2010. The 5-year RI and NRM were comparable between the two periods, except for CR2 patients who transplanted after 2010 and have had lower RI and NRM. Notably, a higher percentage of transplants involved haploidentical and unrelated donors in D2, reflecting evolving transplantation strategies.
Conclusion: Our findings indicate that despite significant advances in transplant techniques, supportive care, and donor availability, OS and DFS have remained relatively stable between the two periods. This is likely due to higher rate of HSCT from alternative donor and in high-risk patient after 2010. The study highlights the need for personalized approaches in managing AML, focusing on optimizing donor selection and addressing transplant-related complications.
Background: Allogeneic hematopoietic stem cell transplantation (HSCT) is considered the only effective therapeutic option for eradicating acute myeloid leukemia (AML) after achieving remission. Evaluating treatment outcomes and addressing challenges at each center are essential for improving conditions and overcoming obstacles. Thus, this study aimed to evaluate the outcomes of HSCT in AML patients who had. undergone transplantation at our center over the past three decades.
Methods: This retrospective cohort study was conducted at the Oncology, Hematology, and Transplant Research Institute on adult AML patients who underwent allogeneic HSCT between January 1991 and January 2022. Data on demographic, clinical, and laboratory characteristics were collected from medical records. The primary objectives included evaluating overall 5-year overall survival (OS) and disease-free survival (DFS) across all patients, and comparing outcomes based on the timing of transplant and pre-transplant remission status. Secondary objectives included assessing non-relapse mortality (NRM) and relapse incidence (RI). Statistical analyses were conducted to compare outcomes between two groups: those who received transplants before 2010 (D1) and those who received transplants after 2010 (D2).
Results: In total, 1,337 AML patients were analyzed, with 477 in group D1 and 860 in group D2. The median follow-up duration was 111 months for D1 and 62 months for D2. OS was similar between the two groups (56.64% for D1 vs. 57.86% for D2), but OS improvements were observed only in patients who underwent transplantation in later remissions (CR2 and CR≥3) after 2010. DFS were also generally similar between the two groups, but significant improvements were noted for CR2 and CR≥3 patients transplanted after 2010. The 5-year RI and NRM were comparable between the two periods, except for CR2 patients who transplanted after 2010 and have had lower RI and NRM. Notably, a higher percentage of transplants involved haploidentical and unrelated donors in D2, reflecting evolving transplantation strategies.
Conclusion: Our findings indicate that despite significant advances in transplant techniques, supportive care, and donor availability, OS and DFS have remained relatively stable between the two periods. This is likely due to higher rate of HSCT from alternative donor and in high-risk patient after 2010. The study highlights the need for personalized approaches in managing AML, focusing on optimizing donor selection and addressing transplant-related complications.
Keywords: Allogeneic hematopoietic stem cell transplantation, acute myeloid leukemia, overall survival, disease-free survival, Bone marrow transplantation, cohort study
Type of Study: Research |
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