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Real-world outcomes and prognostic factors among patients with acute myeloid leukemia treated with allogeneic hematopoietic stem cell transplantation

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Abstract

Acute myeloid leukemia (AML) is a malignant lymphohematopoietic tumor that ranks among the most frequent indications for allogeneic hematopoietic stem cell transplantation (allo-HSCT). This article aims to provide a comprehensive analysis of the application of allo-HSCT for AML and identify prognostic factors to enhance future treatment effect. This retrospective study collected data from 323 patients diagnosed with AML at Peking University First Hospital who underwent allo-HSCT between September 2003 and July 2022. The annual number of transplantations has steadily increased. Our center has observed a rise in the proportion of cytogenetic high-risk and measurable residual disease (MRD) positive patients since 2013, as well as an increase in the number of haploidentical transplantations. The overall leukocyte engraftment time has decreased over the past 20 years. Furthermore, both overall survival (OS) and disease-free survival (DFS) have significantly improved, while non-relapse mortality (NRM) has significantly decreased since 2013. Multivariate analysis identified transplantation before 2013, patients in complete remission (CR) 2 or non-CR, and recipients older than 50 years as risk factors for NRM, while patients in non-CR and patients with positive MRD are risk factors for recurrence. These findings offer insights into AML treatment outcomes in China, highlighting changes in transplantation practices and the need to reduce post-transplant relapse. Effective interventions, such as MRD monitoring and risk stratification schemes, are crucial for further enhancing transplant outcomes.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

This work was financially supported by the National Natural Science Foundation of China (No. 81970410); Beijing Natural Science Foundation (No. 7202203); The Beijing Municipal Science and Technology Commission (No. Z221100007422008); and Peking University First Hospital Scientific Research Seed Fund (No. 2021SF13).

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Author notes

  1. Qingya Wang and Zeyin Liang contributed equally to this work.

Authors and Affiliations

  1. Department of Hematology, Peking University First Hospital, No. 8 Xishiku Street, Beijing, 100034, China

    Qingya Wang, Zeyin Liang, Hanyun Ren, Yujun Dong, Yue Yin, Qingyun Wang, Wei Liu, Bingjie Wang, Na Han, Yangliu Li & Yuan Li

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  1. Qingya Wang
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Contributions

Conceptualization: YL, HYR, and YJD. Methodology: QYaW and ZYL; formal analysis and investigation: QYaW, NH, and YLL; writing — original draft preparation: QYaW; writing — review and editing: YL; supervision: QYunW, WL, YY, and BJW. All authors contributed to the study conception and design. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Yuan Li.

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The study was conducted in accordance with the Declaration of Helsinki and was approved by the institutional review board at Peking University First Hospital (No. 2023-332). Due to the retrospective nature of the study, the requirement for written informed consent was waived. All data used in this manuscript were anonymized to ensure patient confidentiality.

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Wang, Q., Liang, Z., Ren, H. et al. Real-world outcomes and prognostic factors among patients with acute myeloid leukemia treated with allogeneic hematopoietic stem cell transplantation. Ann Hematol 102, 3061–3074 (2023). https://doi.org/10.1007/s00277-023-05429-6

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