Cleveland Clinic Cancer Center (Taussig) Outcomes
Leukemia & Myeloid Disorders
Survival Differences Among Patients with Acute Myeloid Leukemia Treated with Allogeneic Hematopoietic Cell Transplantation Versus Non-HCT Therapies: A Large Real- Time Multi-Center Prospective Longitudinal Observational Study
This was the first prospective multi-center longitudinal study designed dating from first presentation of adults with Acute Myeloid Leukemia to be treated at one of 13 different referral centers that provide both AML treatment and HCT. Survival was compared according to whether or not patients received Hematopoietic Cell Transplantation at later time points.
Comparison of Survival Rates Among Those Who Received HCT Vs. Those Who Did Not Based on Unadjusted and Adjusted Multivariate Models (N = 695)
A prospective observational study, adjusting for key AML-specific and patient-specific variables negated the observed benefit of HCT over non-HCT therapies in reducing mortality rates among AML patients. Our results might reflect 1) improvement in supportive care and non-HCT therapies, 2) a relatively high non-relapse mortality early after HCT and the need for longer follow-up to demonstrate an adjusted benefit of HCT, and 3) the high selectivity of the transplant eligibility process, as we accounted here for variables that are often ignored in "genetic assignment" randomized studies (i.e. comorbidities and function).