ArticleClinical and experimental medicine2025
Second allogeneic stem cell transplantation using different donors as the salvage treatment for acute myeloid leukemia relapsed after allogeneic hematopoietic stem cell transplantation.
Article in Clinical and experimental medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Patients with acute myeloid leukemia (AML) who relapse after the first allogeneic hematopoietic stem cell transplantation (allo-HSCT) are confronted with an extremely poor prognosis, primarily due to the dearth of effective treatment strategies. In light of this critical clinical challenge, we embarked on an in-depth analysis of second salvage allo-HSCT in this high-risk patient population. Between 2019 and 2023, a total of 20 patients diagnosed with relapsed or refractory (r/r) AML received second salvage allo-HSCT at our center. Among these patients, 14 had a mean leukemic cell load of 44.2% (ranging from 5.5 to 97%) in the bone marrow, while the remaining 6 presented with extramedullary lesions. With a median follow-up period of 14.5 months (ranging from 1 to 36 months), 9 patients managed to survive in a leukemia-free state. The expected 2-year overall survival (OS) and leukemia-free survival (LFS) rates were both (45.5 ± 14.0)%. Among the 11 patients who succumbed to the disease, the causes of death were as follows: 1 case of implant failure, 2 cases of severe pneumonia, 1 case of pulmonary graft-versus-host disease (GVHD), and 7 cases of leukemia progression. Our research clearly demonstrates that second allo-HSCT serves as an effective salvage therapy for r/r AML patients following the first transplantation. Moreover, its safety profile is relatively manageable, suggesting its potential value in the clinical treatment of such patients.
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