The long-term outcomes of allogeneic hematopoietic cell transplantation (HCT) with reduced-intensity conditioning (RIC) remain inconclusive. To address this issue, we conducted a nationwide registry-based study of patients with acute myeloid leukemia (AML) age 50 years or older who underwent allogeneic HCT in complete remission using RIC (n = 284) or myeloablative conditioning (MAC, n = 190) between 2002 and 2007. The median follow-up period for surviving patients was 10.1 years for RIC recipients and 10.4 years for MAC recipients. The 10-year probabilities of overall survival, relapse, and non-relapse mortality were 36.4%, 30.0%, and 35.7% for RIC recipients, and 39.8%, 26.3%, and 35.5% for MAC recipients, respectively. Multivariate analysis revealed that the conditioning intensity did not affect overall mortality (P = 0.184), relapse (P = 0.904), or non-relapse mortality (P = 0.387). For the 218 patients qualifying for propensity score-matched pairing (109 pairs), RIC was found to be associated with similar survival (P = 0.095) and relapse (P = 0.467), and significantly lower non-relapse mortality (P = 0.046) compared with MAC. Our results confirm the long-term efficacy of RIC allogeneic HCT for older patients with AML and mitigate concerns over an increase in late relapse.

强度降低（RIC）的同种异体造血细胞移植（HCT）的长期结果尚无定论。为了解决这个问题，我们对年龄在50岁以上的急性髓样白血病（AML）的患者进行了全国性的登记研究，该患者接受RIC（n  = 284）或清髓条件治疗（MAC，n 在2002年至2007年之间的平均随访时间为190岁。RIC接受者的存活患者中位随访期为10.1年，MAC接受者为10.4年。RIC接受者的10年总生存率，复发率和非复发死亡率分别为RIC接受者的36.4％，30.0％和35.7％，而MAC接受者的10年概率分别为39.8％，26.3％和35.5％。多因素分析显示，调节强度不会影响总死亡率（P  = 0.184），复发（P  = 0.904）或非复发死亡率（P  = 0.387）。对于218位符合倾向得分匹配配对的患者（109对），发现RIC与相似的生存率（P  = 0.095）和复发（P = 0.467），并且 与MAC相比，非复发死亡率显着降低（P = 0.046）。我们的结果证实了RIC同种异体HCT对老年AML患者的长期疗效，并减轻了对晚期复发增加的担忧。