Devillier R, Forcade E, Garnier A, et al. In-Depth Time-Dependent Analysis of the Benefit of Allo-HSCT for Elderly Patients With CR1 AML: A FILO Study. Blood Advances. 2021; (doi: 10.1182/bloodadvances.2021004435).
A real-world time-dependent analysis by the French Innovative Leukemia Organization (FILO) found that allogeneic hematopoietic stem cell transplantation (allo-HSCT) can benefit patients over age 60 years with intermediate (IR) and unfavorable risk (UR) acute myeloid leukemia (AML) when performed in first complete remission (CR1). Without allo-HSCT, relapse-free survival (RFS) in this patient population is <10%. The 10-year analysis involved 507 AML patients aged 60–70 years with AML in CR1 after aggressive chemotherapy with IR or UR risk, based on the European LeukemiaNet (ELN)-2010. In all, 203 of the 369 (73%) IR and 138 (27%) UR patients underwent allo-HSCT. Classical multivariate analysis found the procedure improved RFS and overall survival separately from the ELN risk cohort. Multistate analysis calculated an 8% and 1% predicted 5-year probability for IR and UR patients, respectively, to remain in CR1 without allo-HSCT. Dynamic predictions showed patients not treated with allo-HSCT continued to relapse, while the super landmark model confirmed that RFS and OS improved substantially with transplantation.