In-depth time-dependent analysis of the benefit of Allo-HSCT for elderly patients with CR1 AML: a FILO study

Abstract The benefit of allogeneic hematopoietic stem cell transplantation (Allo-HSCT) for acute myeloid leukemia (AML) patients over 60 years remains a matter of debate, notably when performed in first complete remission (CR1). In order to clarify this issue, the French Innovative Leukemia Organization (FILO) performed a 10-year real-world time-dependent analysis. The study enrolled patients between 60 and 70 years of age with AML in CR1 after intensive chemotherapy with intermediate (IR) or unfavorable (UR) risk according to the European LeukemiaNet (ELN)-2010. The impact of Allo-HSCT was analyzed through three models, respectively i) time-dependent Cox, ii) multistate for dynamic prediction and iii) super landmark. The study enrolled 369 (73%) IR and 138 (27%) UR AML patients, 203 of whom received an Allo-HSCT. Classical multivariate analysis showed that Allo-HSCT significantly improved relapse-free (RFS; Hazard Ratio/HR [95%CI]: 0.47 [0.35-0.62], p