Objective To evaluate the efficacy and prognostic factors of allogeneic hematopoietic stem cell transplantation(allo-HSCT)in patients with secondary acute myeloid leukemia(sAML).Methods In this multicenter,retrospective clinical study,adult patients aged ≥18 years who underwent allo-HSCT for sAML at four centers of the Zhejiang Hematopoietic Stem Cell Transplantation Collaborative Group from January 2014 to November 2022 were included,and the efficacy and prognostic factors of allo-HSCT were analyzed.Results A total of 95 patients were enrolled;66(69.5％)had myelodysplastic syndrome-acute myeloid leukemia(MDS-AML),4(4.2％)had MDS/MPN-AML,and 25(26.3％)had therapy-related AML(tAML).The 3-year CIR,LFS,and overall survival(OS)rates were 18.6％(95％CI 10.2％-27.0％),70.6％(95％CI60.8％-80.4％),and 73.3％(95％CI 63.9％-82.7％),respectively.The 3-year CIRs of the M-AML group(including MDS-AML and MDS/MPN-AML)and the tAML group were 20.0％and 16.4％,respectively(P=0.430).The 3-year LFSs were 68.3％and 75.4％,respectively(P=0.176).The 3-year OS rates were 69.7％and 75.4％,respectively(P=0.233).The 3-year CIRs of the groups with and without TP53 mutations were 60.0％and 13.7％,respectively(P=0.003);the 3-year LFSs were 20.0％and 76.5％,respectively(P=0.002);and the 3-year OS rates were 40.0％and 77.6％,respectively(P=0.002).According to European LeukmiaNet 2022(ELN2022)risk stratification,the 3-year CIRs of patients in the low-,intermediate-,and high-risk groups were 8.3％,17.8％,and 22.6％,respectively(P=0.639).The three-year LFSs were 91.7％,69.5％,and 65.6％,respectively(P=0.268).The 3-year OS rates were 91.7％,71.4％,and 70.1％,respectively(P=0.314).Multivariate analysis revealed that advanced disease at allo-HSCT and TP53 mutations were independent risk factors for CIR,LFS,and OS.Conclusion There was no significant difference in the prognosis of patients who underwent allo-HSCT among the MDS-AML,MDS/MPN-AML,and tAML groups.Advanced disease at transplantation and TP53 mutations were poor prognostic factors.ELN2022 risk stratification had limited value for predicting the prognosis of patients with sAML following allo-HSCT.
维普
万方数据
