Comparison of Post-Remission Strategies in Acute Myeloid Leukemia: Autologous Hematopoietic Stem Cell Transplantation versus Consolidation Chemotherapy

Autologous Hematopoietic Stem Cell Transplantation (auto-HSCT) has become a therapeutic option for first-line consolidation in Acute Myeloid Leukemia (AML) patients with favorable and intermediate risk features. A total of 101 AML patients in first complete remission, who were not eligible for allogeneic HSCT, were randomized to receive intensive cytarabine-based chemotherapy or to undergo auto-HSCT. The probability of LFS was significantly better in auto-HSCT recipients compared to chemotherapy arm (43% vs. 4.8%, p = 0.008). At the end of 915 (30–4470) days of followup, the probability of overall survival was better in auto-HSCT group compared to chemotherapy, without statistical significance (79.2% vs. 38.8%, p = 0.054). Multivariate analysis revealed a significant predictive impact of cytogenetic risk status on OS (p = 0.002, HR: 2.824, 95% CI: 1.445–5.521). Auto-HSCT is considered as an effective consolidation approach in favorable and intermadiate risk AML patients.