Short-course high-dose cytarabine consolidation therapy before allogeneic hematopoietic stem cell transplantation improves 2-year relapse-free survival but not overall survival in patients with acute myeloid leukemia: a single-center retrospective st

The role of consolidation therapy and the optimal number of consolidation cycles prior to allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with acute myeloid leukemia (AML) remains controversial. We retrospectively analyzed 205 patients with acute myeloid leukemia (AML) who underwent allogeneic hematopoietic stem cell transplantation. Patients were stratified into subgroups based on the receipt of consolidation therapy, the number of consolidation treatment cycles, and the dosage of cytarabine. Outcomes including overall survival (OS), progression-free survival (PFS), cumulative incidence of relapse (CIR), treatment-related mortality (TRM), incidence of transplantation-associated complications, and the prognostic impact of minimal residual disease (MRD) status were evaluated separately in each subgroup. At a median follow-up of 24 months, no significant differences were observed in 2-year OS or RFS between the consolidation and non-consolidation groups (OS: 73.1% vs. 66.6%, P = 0.510; RFS: 68.2% vs. 60.6%, P = 0.419). However, patients receiving short-course high-dose cytarabine (SC-HDAC) exhibited significantly improved 2-year RFS compared to those receiving intermediate-/low-dose cytarabine (ID/LDAC) or no consolidation (78.3% vs. 62.4% vs. 56.0%, P = 0.042). MRD clearance rates were comparable between the SC and LC groups (35.7% vs. 33.3%). Successful engraftment was achieved in 98% of patients. In conclusion, Short-Course HDAC consolidation prior to allo-HSCT is associated with improved 2-year RFS in AML patients without increasing treatment-related risks.