High-dose cytarabine chemotherapy (≥4 g/m²/day) before allogeneic hematopoietic stem cell transplantation for non-core-binding-factor AML in the first complete remission

Abstract

Benefit of high-dose cytarabine (HD-AraC) for acute myeloid leukemia (AML) prior to allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains unknown. We retrospectively analyzed data from 79 non-core-binding-factor AML patients who underwent allo-HSCT in their first complete remission (CR1). In univariate analysis, HD-AraC (≥4 g/m²/day) before allo-HSCT improved disease-free survival (DFS) (p = .018), overall survival (OS) (p = .029), and cumulative incidence of relapse (CIR) (p = .033). Four-year DFS, OS, and CIR of patients receiving and not receiving HD-AraC were 79% vs. 49%, 82% vs. 56%, and 18% vs. 42%, respectively. In multivariate analysis, HD-AraC was a positive prognostic factor for DFS (hazard ratio (HR) = 0.36, 95% confidence interval (CI): 0.14–0.88), OS (HR  =  0.37, 95% CI: 0.14–0.99), and CIR (HR  =  0.38, 95% CI; 0.14–1.0). Our study demonstrates that HD-AraC before allo-HSCT at a dose ≥4 g/m²/day is effective for treating AML patients in CR1.

Keywords:

• Acute myeloid leukemia
• first complete remission
• allogeneic hematopoietic stem cell transplantation
• high dose cytarabine
• consolidation chemotherapy

Acknowledgements

The authors are grateful to the medical, nursing, and laboratory staff of the participating departments for their contributions to this study.

Disclosure statement

The authors report no conflict of interest.