The present study evaluated outcomes and prognostic factors in adult patients with acute myeloid leukemia (AML) after syngeneic hematopoietic stem cell transplantation (HSCT). Among patients in first complete remission (CR1), outcomes of syngeneic HSCT (Syn) were compared with those of autologous HSCT (Auto), allogeneic HSCT from human leukocyte antigen (HLA)-matched sibling donor (MSD), or allogeneic HSCT from HLA-matched unrelated donor (MUD). Among 11,866 patients receiving first HSCT, 26 in the Syn group were analyzed. The 5-year overall survival (OS) rate, the cumulative incidence of relapse, and the cumulative incidence of non-relapse mortality (NRM) were 47.8%, 59.6%, and 4.6%, respectively. The OS was significantly better in patients in CR1 (n = 13) than in patients in non-CR1 (P = 0.012). Furthermore, 39 patients in CR1 each were assigned to the Auto, MSD, and MUD groups using propensity score matching. The 5-year OS in the Syn (68.4%) was not significantly different from those in the Auto (55.9%, P = 0.265), MSD (62.4%, P = 0.419), or MUD (63.7%, P = 0.409) groups. A higher relapse in the Syn than in the MSD and MUD groups was offset by lower NRM. In summary, syngeneic HSCT might be an alternative option for AML patients in CR1.

本研究评估了成人急性髓细胞白血病 (AML) 同基因造血干细胞移植 (HSCT) 后的结果和预后因素。在首次完全缓解 (CR1) 的患者中，将同基因 HSCT (Syn) 的结果与自体 HSCT (Auto)、来自人类白细胞抗原 (HLA) 匹配的同胞供体 (MSD) 的同种异体 HSCT 或来自 HLA 的同种异体 HSCT 的结果进行比较-匹配的无关供体（MUD）。在接受首次 HSCT 的 11,866 名患者中，分析了 Syn 组中的 26 名。5年总生存率（OS）、累计复发率和累计非复发死亡率（NRM）分别为47.8%、59.6%和4.6%。CR1（ n = 13）患者的 OS 明显优于 非 CR1（P = 0.012)。此外，使用倾向评分匹配将 CR1 中的 39 名患者分别分配到 Auto、MSD 和 MUD 组。Syn (68.4%) 的 5 年 OS 与 Auto (55.9%, P  = 0.265)、MSD (62.4%, P  = 0.419) 或 MUD (63.7%, P  = 0.409)没有显着差异团体。Syn 组的复发率高于 MSD 组和 MUD 组，这被较低的 NRM 所抵消。总之，同基因 HSCT 可能是 CR1 AML 患者的替代选择。