PMID- 38267560 OWN - NLM STAT- Publisher LR - 20240124 IS - 1432-0584 (Electronic) IS - 0939-5555 (Linking) DP - 2024 Jan 25 TI - Auto-hematopoietic stem cell transplantation or chemotherapy? Meta-analysis of clinical choice for AML. LID - 10.1007/s00277-024-05632-z [doi] AB - For patients with acute myeloid leukemia (AML) who are not candidates for allogeneic stem cell transplantation (SCT) or do not have a human leukocyte antigen (HLA)-matched donor, it is unclear whether autologous SCT (ASCT) has a better prognosis after the first complete response (CR1) compared to further chemotherapy treatment. A meta-analysis evaluating ASCT compared to further chemotherapy for AML patients in CR1 was performed. The Medline, Embase, Cochrane Controlled Trials Registry, Cochrane Library, Web of Science, and National Knowledge Infrastructure of China databases were searched for relevant literature as of May 26, 2023. Eligible studies included prospectively enrolled adults with AML and randomized first-time respondent patients who did not have a matched sibling donor. Fourteen randomized controlled trials were identified and included 4281 participants, of which 1499 patients received ASCT and 2782 underwent chemotherapy and continued follow-up. In patients with AML in CR1, a lower relapse rate was associated with ASCT compared to chemotherapy [odds ratio (OR) = 0.49, 95% confidence interval (CI) = 0.41-0.57]. Significant disease-free survival (DFS; OR = 1.37, 95% CI = 1.02-1.84) and relapse-free survival (RFS; OR = 2.78, 95% CI = 1.28-6.02) ASCT benefits were documented, and there was no difference in the overall survival (OS) when the studies were pooled (OR = 1.12, 95% CI = 0.85-1.48). The study results indicated that after the first remission, AML patients receiving autologous stem cell transplantation had higher DFS and RFS, similar OS, and lower relapse compared to patients undergoing chemotherapy treatment. This indicated that autologous stem cell transplantation may have a better prognosis. CI - (c) 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature. FAU - Ge, Songyu AU - Ge S AUID- ORCID: 0009-0000-3094-7113 AD - First Clinical College, China Medical University, Shenyang, Liaoning Province, China. FAU - Wang, Jining AU - Wang J AUID- ORCID: 0009-0009-7760-9352 AD - Second Clinical College, China Medical University, Shenyang, Liaoning Province, China. FAU - He, Qin AU - He Q AUID- ORCID: 0000-0002-2689-6963 AD - Department of Hematology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China. FAU - Zhu, Jiaqi AU - Zhu J AD - Department of Hematology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China. FAU - Liu, Pai AU - Liu P AUID- ORCID: 0009-0003-4493-4614 AD - Department of Hematology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China. FAU - Wang, Hongtao AU - Wang H AUID- ORCID: 0000-0002-6095-7774 AD - Department of Hematology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China. wanght@si-hospital.org. FAU - Zhang, Fan AU - Zhang F AUID- ORCID: 0000-0002-0176-2715 AD - Department of Hematology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China. zhf935@163.com. LA - eng GR - 81600115/National Natural Science Foundation of China/ PT - Journal Article PT - Review DEP - 20240125 PL - Germany TA - Ann Hematol JT - Annals of hematology JID - 9107334 SB - IM OTO - NOTNLM OT - AML OT - Auto-HSCT OT - Chemotherapy OT - Disease-free survival OT - Relapse EDAT- 2024/01/25 00:42 MHDA- 2024/01/25 00:42 CRDT- 2024/01/24 23:21 PHST- 2023/11/14 00:00 [received] PHST- 2024/01/13 00:00 [accepted] PHST- 2024/01/25 00:42 [medline] PHST- 2024/01/25 00:42 [pubmed] PHST- 2024/01/24 23:21 [entrez] AID - 10.1007/s00277-024-05632-z [pii] AID - 10.1007/s00277-024-05632-z [doi] PST - aheadofprint SO - Ann Hematol. 2024 Jan 25. doi: 10.1007/s00277-024-05632-z.