Multicenter studies comparing alloHCT to non-HCT consolidation strategies in older patients with AML or MDS
| Study . | N . | Age range . | Study design disease . | Comparison groups . | AlloHCT donor source/conditioning . | Survival outcomes . | Comments . |
|---|---|---|---|---|---|---|---|
| Farag et al. (2011)11 | AlloHCT: 94 Non-HCT: 96 | 60-70 | Retrospective, multicenter analysis AML in CR1 | AlloHCT: CIBMTR Registry Non-HCT: CT in CALGB | Matched: 77% Alternative: 23% RIC/NMA: 100% | 3-year OS: AlloHCT: 37% Non-HCT: 25% 3-year LFS: AlloHCT: 32% Non-HCT: 15% | OS benefit in all cytogenetic risk groups. |
| Kurosawa et al. (2011)12 | AlloHCT: 152 Non-HCT: 884 | 50-70 | Retrospective, multicenter analysis AML in CR1 | AlloHCT: Japanese Registry Non-HCT: Japanese Registry | Matched: 76% Alternative: 24% (15% cord) MA: 38% RIC/NMA: 62% | 3-year OS: AlloHCT: 62% Non-HCT: 51% 3-year RFS: AlloHCT: 56% Non-HCT: 29% | 183 patients in the CT group eventually received HCT. OS benefits in intermediate-risk group. |
| Versluis et al. (2015)13 | AlloHCT: 97 Non-HCT: 177 None: 366 | ≥60 | Retrospective analysis of multicenter trials AML in CR1 | AlloHCT: HOVON-SAKK trials Non-HCT: HOVON-SAKK trials | Matched: 92% Alternative: 8% RIC/NMA: 100% | 5-year OS: AlloHCT: 35% Non-HCT: 26% 5-year RFS: AlloHCT: 32% Non-HCT: 20% | Benefits are seen in both intermediate-risk and adverse risk groups. |
| Ustun et al. (2019)10 | AlloHCT: 431 Non-HCT: 211 | 60-77 | Retrospective, multicenter analysis AML in CR1 | AlloHCT: CIBMTR Registry Non-HCT: CT in cooperative group trials (CALGB, SWOG, ECOG) | Matched: 65% Alternative: 35% (24% cord) MA: 29% RIC/NMA: 71% | 5-year OS: AlloHCT: 28.6% Non-HCT: 13.8% 5-year DFS: AlloHCT: 23.7% Non-HCT: 11.1% | OS/DFS is worse in the first 9 months for alloHCT. OS/DFS benefits more for poor-risk patients. |
| *Niederwieser et al. (2016) ASCO Abstract e18501 | AlloHCT: 150 (donor) Non-HCT: 205 (no donor) | 50-75 | Prospective, intent-to-treat, donor vs no-donor trial AML in CR1 | AlloHCT: Donor group Non-HCT: No donor consolidation group | Matched: 79% Mismatched: 21% RIC/NMA: 100% | 9-year LFS: Donor: 25% No donor: 14% 9-year RI: Donor: 42% No donor: 78% | Benefits seen across both intermediate- and high-risk groups. |
| *Brune et al. (2018) ASH Abstract 205 | AlloHCT: 77 (donor) Non-HCT: 68 (no donor) | 50-70 | Prospective, intent-to-treat, donor vs no-donor trial AML in CR1 | AlloHCT: Donor group Non-HCT: No donor consolidation group | Matched: 100% RIC/NMA: 100% | 3-year OS: Donor: 45% No donor: 48% 3-year RFS: Donor: 40% No donor: 35% | 7 patients in control group crossed over. Extremely high relapse rate in both arms (49% vs 60%) |
| *Foran et al. (2018) EHA Abstract S857 (ECOG E2906) | AlloHCT: 135 (donor) Non-HCT: 225 (no donor) | ≥60 | Prospective, intent-to-treat, donor vs no-donor trial AML in CR1 | AlloHCT: Donor group Non-HCT: No donor consolidation group | Matched: 100% RIC/NMA: 100% | Median OS: Donor: 22.1 months No donor: 13.4 months (P = .013) | 44 patients in the donor group and 25 patients in the no-donor group crossed over. |
| Nakamura et al. (2021) (BMT CTN 1102)14 | AlloHCT: 260 (donor) Non-HCT: 124 (no donor) | 50-75 | Prospective, intent-to-treat, donor vs no-donor trial MDS IPSS Intermediate-2/high risk | AlloHCT: Donor group Non-HCT: No donor consolidation group | Matched: 100% RIC/NMA: 100% | 3-year OS: Donor: 47.9% No donor: 26.6% 3-year OS (as treated analysis): AlloHCT: 47.4% Non-HCT: 16% | Similar benefits in 3-year LFS. No decrease in QOL. |
| Study . | N . | Age range . | Study design disease . | Comparison groups . | AlloHCT donor source/conditioning . | Survival outcomes . | Comments . |
|---|---|---|---|---|---|---|---|
| Farag et al. (2011)11 | AlloHCT: 94 Non-HCT: 96 | 60-70 | Retrospective, multicenter analysis AML in CR1 | AlloHCT: CIBMTR Registry Non-HCT: CT in CALGB | Matched: 77% Alternative: 23% RIC/NMA: 100% | 3-year OS: AlloHCT: 37% Non-HCT: 25% 3-year LFS: AlloHCT: 32% Non-HCT: 15% | OS benefit in all cytogenetic risk groups. |
| Kurosawa et al. (2011)12 | AlloHCT: 152 Non-HCT: 884 | 50-70 | Retrospective, multicenter analysis AML in CR1 | AlloHCT: Japanese Registry Non-HCT: Japanese Registry | Matched: 76% Alternative: 24% (15% cord) MA: 38% RIC/NMA: 62% | 3-year OS: AlloHCT: 62% Non-HCT: 51% 3-year RFS: AlloHCT: 56% Non-HCT: 29% | 183 patients in the CT group eventually received HCT. OS benefits in intermediate-risk group. |
| Versluis et al. (2015)13 | AlloHCT: 97 Non-HCT: 177 None: 366 | ≥60 | Retrospective analysis of multicenter trials AML in CR1 | AlloHCT: HOVON-SAKK trials Non-HCT: HOVON-SAKK trials | Matched: 92% Alternative: 8% RIC/NMA: 100% | 5-year OS: AlloHCT: 35% Non-HCT: 26% 5-year RFS: AlloHCT: 32% Non-HCT: 20% | Benefits are seen in both intermediate-risk and adverse risk groups. |
| Ustun et al. (2019)10 | AlloHCT: 431 Non-HCT: 211 | 60-77 | Retrospective, multicenter analysis AML in CR1 | AlloHCT: CIBMTR Registry Non-HCT: CT in cooperative group trials (CALGB, SWOG, ECOG) | Matched: 65% Alternative: 35% (24% cord) MA: 29% RIC/NMA: 71% | 5-year OS: AlloHCT: 28.6% Non-HCT: 13.8% 5-year DFS: AlloHCT: 23.7% Non-HCT: 11.1% | OS/DFS is worse in the first 9 months for alloHCT. OS/DFS benefits more for poor-risk patients. |
| *Niederwieser et al. (2016) ASCO Abstract e18501 | AlloHCT: 150 (donor) Non-HCT: 205 (no donor) | 50-75 | Prospective, intent-to-treat, donor vs no-donor trial AML in CR1 | AlloHCT: Donor group Non-HCT: No donor consolidation group | Matched: 79% Mismatched: 21% RIC/NMA: 100% | 9-year LFS: Donor: 25% No donor: 14% 9-year RI: Donor: 42% No donor: 78% | Benefits seen across both intermediate- and high-risk groups. |
| *Brune et al. (2018) ASH Abstract 205 | AlloHCT: 77 (donor) Non-HCT: 68 (no donor) | 50-70 | Prospective, intent-to-treat, donor vs no-donor trial AML in CR1 | AlloHCT: Donor group Non-HCT: No donor consolidation group | Matched: 100% RIC/NMA: 100% | 3-year OS: Donor: 45% No donor: 48% 3-year RFS: Donor: 40% No donor: 35% | 7 patients in control group crossed over. Extremely high relapse rate in both arms (49% vs 60%) |
| *Foran et al. (2018) EHA Abstract S857 (ECOG E2906) | AlloHCT: 135 (donor) Non-HCT: 225 (no donor) | ≥60 | Prospective, intent-to-treat, donor vs no-donor trial AML in CR1 | AlloHCT: Donor group Non-HCT: No donor consolidation group | Matched: 100% RIC/NMA: 100% | Median OS: Donor: 22.1 months No donor: 13.4 months (P = .013) | 44 patients in the donor group and 25 patients in the no-donor group crossed over. |
| Nakamura et al. (2021) (BMT CTN 1102)14 | AlloHCT: 260 (donor) Non-HCT: 124 (no donor) | 50-75 | Prospective, intent-to-treat, donor vs no-donor trial MDS IPSS Intermediate-2/high risk | AlloHCT: Donor group Non-HCT: No donor consolidation group | Matched: 100% RIC/NMA: 100% | 3-year OS: Donor: 47.9% No donor: 26.6% 3-year OS (as treated analysis): AlloHCT: 47.4% Non-HCT: 16% | Similar benefits in 3-year LFS. No decrease in QOL. |
Meeting abstract only. ASCO, American Society of Clinical Oncology; ASH, American Society of Hematology; CALGB, Cancer and Leukemia Group B; CR1, first complete remission; CT, chemotherapy consolidation; DFS, disease-free survival; ECOG, Eastern Cooperative Oncology Group; EHA, European Hematology Association; HOVON-SAKK, Dutch-Belgian Hemato-Oncology Cooperative Group and the Swiss Group for Clinical Cancer Research; IPSS, International Prognostic Scoring System; LFS, leukemia-free survival; MA, myeloablative conditioning; RFS, relapse free survival; RI, relapse incidence; RIC/NMA, reduced-intensity/nonmyeloablative conditioning; SWOG, Southwest Oncology Group.