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Annals of Hematology

, Volume 97, Issue 9, pp 1519–1526 | Cite as

Effects of post-remission chemotherapy before allo-HSCT for acute myeloid leukemia during first complete remission: a meta-analysis

  • Yangmin Zhu
  • Qingyan Gao
  • Jun Du
  • Jing Hu
  • Xu Liu
  • Fengkui Zhang
Review Article

Abstract

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is most frequently used to treat acute myeloid leukemia (AML). Whether patients should routinely receive consolidation chemotherapy before proceeding to transplant after achieving first complete remission (CR1) has been a subject of debate. We performed a systematic review and meta-analysis of studies examining the impact of post-remission chemotherapy before allo-HSCT in patients with AML in CR1. Six studies including 1659 patients were included in the meta-analysis. The pooled hazard ratio (HR) for overall survival was 0.9 (95% confidence interval [CI] 0.77–1.05, P = 0.182), and the pooled HR for leukemia-free survival was 0.87 (95% CI 0.75–1.0, P = 0.07). No survival advantage was observed for post-remission chemotherapy before reduced-intensity conditioning or myeloablative conditioning (MAC) allo-HSCT for AML in CR1. The pooled relative risk for relapse incidence (RI) was 1.02 (95% CI 0.82–1.28, P = 0.834). Post-remission chemotherapy before allo-HSCT did not significantly affect the RI in patients with AML in CR1. The analyses revealed no significant benefit of post-remission consolidation chemotherapy in patients who received allo-HSCT. We recommend proceeding to allo-HSCT as soon as CR1 is attained.

Keywords

Post-remission chemotherapy Allo-HSCT Acute myeloid leukemia Meta-analysis 

Notes

Acknowledgments

We sincerely thank all patients and clinical investigators who were involved in the studies selected for this meta-analysis.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Therapeutic Centre of Anemia, Institute of Hematology and Blood Diseases HospitalChinese Academy of Medical Science & Peking Union Medical College (CAMS & PUMC)TianjinPeople’s Republic of China

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