We assessed outcomes of allogeneic transplantation (HSCT) in favorable risk AML in CR1 over 3 time periods. 1850 patients were included, 2005 to 2009- 222, 2010 to 2014 -392, and 2015 to 2021-1236; 526 with t (8:21), 625 with inv (16), and 699 with NPM1mutFLT3WT. Patients transplanted in 2015-2021 were older (p < 0.0001) with more patients ≥60 years of age (p < 0.0001). The most frequent diagnosis in 2015-2021 was NPM1mutFLT3WT vs. t (8:21) in the 2 earlier periods, (p < 0001). Haploidentical transplants (Haplo) increased from 5.9% to 14.5% (p < 0.0001). Graft-versus-host disease (GVHD) prophylaxis with post-transplant cyclophosphamide (PTCy) was more frequent in 2015-2021 vs. the other 2 periods (p < 0.0001). On multivariate analysis, incidence of total chronic GVHD was reduced in HSCTs performed ≥2015 vs. those performed in 2005-2009, hazard ratio (HR) = 0.74 (95% CI 0.56-0.99, p = 0.046) and GVHD-free, relapse-free survival (GRFS) improved for patients transplanted from 2010-2014 vs. those transplanted in 2005-2009, HR = 0.74 (95% CI 0.56-0.98, p = 0.037). Other HSCT outcomes did not differ with no improvement ≥2015. LFS, OS, and GRFS were inferior in patients with t (8:21) with HR = 1.32 (95% CI 1.03-1.68, p = 0.026), HR = 1.38 (95% CI 1.04-1.83, p = 0.027) and HR = 01.25 (95% CI 1.02-1.53, p = 0.035), respectively. In conclusion, this retrospective analysis of HSCT in patients with favorable risk AML, transplanted over 16 years showed an increased number of transplants in patients ≥60 years, from Haplo donors with PTCy. Most importantly, 3-year GRFS improved ≥2010 and total chronic GVHD reduced ≥2015, with no significant change in other HSCT outcomes.

1st Affiliated Hospital of Soochow University Suzhou China

CHU Bordeaux Hopital Haut L'évêque Pessac France

CHU Nantes Nantes France

Dél pesti Centrumkórház Budapest Hungary

Department of Oncology and Hematology University of Milan and Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII Bergamo Italy

Division of Hematology Sheba Medical Center Tel Hashomer Israel

EBMT Paris study office; Department of Haematology Saint Antoine Hospital; INSERM UMR 938 Sorbonne University Paris France

Goethe Universitaet Frankfurt Main Germany

HUCH Comprehensive Cancer Center Helsinki Finland

Institute of Hematology and Blood Transfusion Prague Czech Republic

Institute of Hematology and Transfusion Medicine Warsaw Poland

IRCCS Osspedale San Raffaele Vita Salute San Raffaele University Haematology and BMT Milano Italy

King Faisal Specialist Hospital and Research Centre Riyadh Saudi Arabia

Klinikum Augsburg Augsburg Germany

Leiden University Medical Center Leiden The Netherlands

Programme de Transplantation and Therapie Cellulaire Marseille France

Sorbonne University Department of Haematology Saint Antoine Hospital; INSERM UMR 938 Paris France

University Hospital Birmingham NHS Trust Stoke UK

University Hospital Gasthuisberg Leuven Belgium

University Medical Center Hamburg Hamburg Germany

University Paris Cité INSERM UMR 976 APHP Saint Louis Hospital BMT Unit Paris France

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