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Objective: To discover the function of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in ASXL1-mutated acute myeloid leukemia (AML) patients. Methods: We analyzed the prognostic value of ASXL1 mutations and explored the role of allo-HSCT in 581 AML patients. Results: According to the definition of intermediate- and adverse-risk AML groups in the European Leukemia Net (ELN), ASXL1-mutated patients had shorter OS and DFS than ASXL1-wild-type patients in the intermediate- and adverse-risk AML groups (3-year OS: 47.5% vs. 60.8%, PConclusion: The results indicate that the presence of ASXL1 mutations is a factor predictive of poor prognosis in AML patients and allo-HSCT could improve the survival of AML patients with ASXL1 mutations.

The role of MRD-directed risk stratification strategy for core binding factor acute myeloid leukemia (CBF-AML) patients with favorable risk genetics is still unknown. We retrospectively analyzed the clinical outcomes of 148 pure CBF-AML patients with first complete remission including MRD positive (

This retrospective study tested the feasibility of decitabine (DAC) plus intermediate-dose cytarabine (ID-AraC) followed by HLA-mismatched granulocyte colony-stimulating factor (G-CSF)-mobilized peripheral donor blood stem cells (GPBSCs) infusion as consolidation treatment for older patients with acute myeloid leukemia (AML) in first complete remission (CR). A total of 23 patients received this regimen for 3 cycles (D-GPBSCs group), and the outcome was compared with that of 19 patients treated with repeated cycles of ID-AraC chemotherapy (chemo group). The two regimens were well tolerated. The median recovery times for neutrophils and platelets were shorter in D-GPBSCs group than in chemo group (p.05). No graft-versus-host disease (GVHD) was observed in D-GPBSCs group. The 2-year leukemia-free survival (LFS) and overall survival (OS) were better in D-GPBSCs group (51.6 and 55.4%) than in chemo group (27.1 and 34.2%) (p = .047 and p = .056). These data suggest that DAC and ID-AraC followed by GPBSCs as a consolidation regimen may be a safe and promising option for older patients with AML.

Patients with refractory or relapsed acute myeloid leukemia (AML) receiving allogeneic hematopoietic stem cell transplant (HSCT) were retrospectively assessed to evaluate the effect of disease burden on outcomes and to identify predictive variables. Of all patients, 53 achieved a complete morphological remission (CR-AML) before transplant, while 48 failed to do so (NR-AML). In the CR-AML group, 32 patients displayed minimal residual disease (MRDpos). Estimated 5-year overall survival (5-OS) and disease-free survival of all patients was 37% and 29%, respectively. The 5-OS was significantly different between patients with CR-AML and NR-AML (46% vs. 18%). However, pre-transplant MRD status did not affect 5-OS (51% in MRDneg vs. 41% in MRDpos). Using multivariate analysis, we identified patient's physical condition and risk stratification as additional prognostic factors. Our findings suggest that NR status influences the outcomes of HSCT while pre-transplant MRD does not. HSCT needs to be optimized accordingly to treat high risk AML.