Lack of Evidence Supporting a Significant Benefit of Pre-Transplant Consolidation Therapy in AML CR2 Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation.

: Allogeneic hematopoietic stem cell transplantation (HSCT) is a well-established curative treatment option for acute myeloid leukemia (AML) in second complete remission (CR2). However, whether the addition of consolidation chemotherapy after achieving CR2 can improve transplant outcomes remains controversial. : In this single-center retrospective study, we analyzed consecutive AML patients who underwent their first HSCT in CR2 at our institution between January 2015 and December 2019. : For the consolidation ( = 72) and no consolidation groups ( = 63), the 5-year cumulative incidence of relapse (CIR) was (17.6% vs. 19.9%; = 0.54), the 5-year non-relapse mortality rate (NRM) was (9.7% vs. 17.5%; = 0.20), the 5-year leukemia-free survival (LFS) was (72.7% vs. 62.7%; = 0.15), and the 5-year overall survival (OS) was (81.9% vs. 68.3%; = 0.08). Additional consolidation therapy to achieve negative measurable residual disease (MRD) did not result in significantly improved outcomes compared to immediate HSCT in MRD positive status, with similar LFS (76.9% vs. 67.0%, = 0.2) and OS (88.3% vs. 75.0%, = 0.14). Multivariable analysis indicated that consolidation chemotherapy did not significantly affect CIR, NRM, LFS, or OS. : Our findings suggest no significant differences in clinical outcomes between the groups, indicating that AML patients in CR2 might proceed to HSCT without delay.