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Stem Cell Transplant Benefits Leukemia in Remission

Benefit only for patients with cytogenetically intermediate- and high-risk disease

TUESDAY, June 9 (HealthDay News) -- Allogeneic stem cell transplantation can improve outcomes for leukemia patients in remission, but primarily for patients with higher-risk disease, according to a study in the June 10 issue of the Journal of the American Medical Association.

John Koreth, from the Dana Farber Cancer Institute in Boston, and colleagues reviewed the literature and pooled the results of 24 prospective clinical trials (6,007 patients), comparing allogeneic stem cell transplantation and nonallogeneic stem cell transplantation therapies for acute myeloid leukemia in first complete remission.

The researchers found that allogeneic stem cell transplantation reduced the risk of relapse or death (hazard ratio, 0.80). The improvement in recurrence-free survival was limited to cytogenetically poor-risk (hazard ratio, 0.69) and intermediate-risk (hazard ratio, 0.76) disease. Allogeneic stem cell transplantation also reduced the risk of death (hazard ratio, 0.90). Similarly, the authors note, this improvement was limited to patients with poor-risk (hazard ratio, 0.73) and intermediate-risk (hazard ratio, 0.83) leukemia.

"Compared with nonallogeneic stem cell transplantation therapies, allogeneic stem cell transplantation has significant recurrence-free survival and overall survival benefit for intermediate- and poor-risk acute myeloid leukemia but not for good-risk acute myeloid leukemia in first complete remission," Koreth and colleagues conclude.

Authors of the study reported financial relationships with the pharmaceutical industry.

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