Treatment of Acute Myeloid Leukemias and Myelodisplastic Syndromes Relapsing After Allogeneic Stem Cell Transplantation: An In-Depth Analysis of the GITMO AML/MDS-Relapse Registry Study

MicroabstractAML and MDS relapse is the most frequent cause of allo-SCT failure. This subanalysis of the GITMO AML/MDS relapse study focuses on 647 AML/MDS relapses that were treated with either HMAs-based therapy (n = 308) or other treatments (n = 339), including intensive chemotherapy, FLT3-inhibitors, and second allo-SCT. The ORR with or without HMA-based salvage treatment was 33% versus 40%, respectively (P = .006). The long-term OS and TRM of the two groups were superimposable. Independently from the type of salvage, an advantage in OS was observed when DLI was included (P < .001). Relapse within 12 months after SCT, low disease burden at relapse, and the CR status at transplant confirmed their independent strong prognostic impact on both HMA and non-HMA-based group (HR 0.05, 0.44, 0.49 and HR 0.19, 0.32, 0.53, respectively).Despite the lower ORR observed with HMA-based therapy, the long-term OS was comparable to that observed with other therapies. The immune control of the disease relapse with DLI is of benefit, independently from the salvage therapy