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Background: Relapsed acute myeloid leukemia (R/R AML) has a poor prognosis with limited therapeutic options.Methods: Consecutive R/R AML adults treated at a reference center from 2010 to 2020 were evaluated.Outcomes were compared between those who received intensive chemotherapy (IC) vs. non-IC (NIC) as the first salvage therapy.Outcomes after outpatient allogeneic hematopoietic cell transplantation (allo-HSCT) were assessed.Cumulative incidence of relapse after the second complete remission (CR2) was determined, and survival was measured by the Kaplan-Meier method; Cox regression was used for multivariate analysis.Results: Forty-three R/R AML patients were included in the study; 34 (79%) received IC and 9 (21%) NIC.Mitoxantrone-etoposide-cytarabine (MEC) was predominantly used as IC.13/34 (38.2%) patients receiving IC achieved CR2 versus none with NIC.Sixteen (37.2%) patients underwent outpatient allo-HSCT.The 1-year cumulative incidence of relapse after CR2 was 38% for allografted patients versus 81% for not allografted patients (p = 0.002).Median survival was 9.1 months for IC versus 6.1 for NIC (p = 0.2).Six-month OS was 86% for patients allografted at CR2, 67% for those allografted without CR2, and 42% for non-allografted patients (p = 0.008).Allo-HSCT (p = 0.02) and CR2 (p = 0.02) were predictive for longer survival.Conclusions: Intensive salvage chemotherapy and outpatient allo-HSCT offer a survival advantage to treat R/R AML.
Jaime‐Pérez et al. (Thu,) studied this question.