Abstract:

Objective To investigate the risk factors of relapse following allogeneic hematopoietic stem cell transplantation（allo-HSCT） in patients with acute myeloid leukemia（AML），and to provide a reference for early clinical identification of high risk factors and timely intervention. Methods A retrospective study of 132 patients diagnosed with AML and treated with allo-HSCT in Shanghai General Hospital of Shanghai Jiao Tong University School fo Medicine from January 1st 2017 to December 31st 2020 was performed. Cox regression analysis was used to evaluate the influence factors of relapse following allo-HSCT. Results Out of 132 cases，25 cases relapsed after allo-HSCT. The median time of relapse was 5 months. TP53 gene mutation and pre-transplant status had statistical significance between relapsed group and non-relapsed group（P<0.05）. Multivariate Cox regression analysis showed that white blood cell count ≥100×10⁹/L at first diagnosis，TP53 gene mutation and no remission（NR） before transplantation were independent risk factors for relapse after allo-HSCT（P<0.05）. Log-rank χ² test showed that there was statistical significance in relapse free survival（RFS） between white blood cell count ≥100×10⁹/L and <100×10⁹/L groups at first diagnosis，TP53 gene mutation group and wild type group，NR group and complete remission（CR） group before transplantation（P<0.05）. Conclusions White blood cell count ≥100×10⁹/L at first diagnosis，TP53 gene mutation and NR before transplantation are associated with high risk of relapse after allo-HSCT in AML patients.

Key words: Acute myeloid leukemia, Allogeneic hematopoietic stem cell transplantation, Relapse, Risk factor