Outcomes of Allogeneic Hematopoietic Cell Transplantation in Chronic Myelomonocytic Leukemia: A National Cancer Database Analysis.

Introduction Allo-HCT is the only potentially curative therapy for Chronic Myelomonocytic Leukemia (CMML). Objectives To study the impact of allo-HCT on survival of CMML patients. Method We compared the survival outcomes of patients who received (or not) an allo-HCT as a part of their front-line treatment strategy using The National Cancer Database (NCDB) from 2004-2015. Results A total of 8,208 CMML patients were identified, but only 153 were allografted. Median follow-up of survivors was 33.6 months (95% CI=39.6-42.6). Allo-HCT recipients were more likely to be younger, of the male gender, had lower Charlson/Deyo co-morbidity score, had a higher median household income, being treated at an academic facility and having private insurance (Table 1). For survival analysis, we excluded 4484 patients who did not receive front-line therapy to better assess impact of allo-HCT on overall survival (OS). The median OS for patients who received chemotherapy alone or chemotherapy + allo-HCT was 13.3 (95% CI=12.7-14.0) months and 47.4 (14.5-80.4) months, respectively (p <0.001, Figure 1) After adjusting for baseline characteristics using Cox-regression modeling, allo-HCT results in better OS (HR=0.45, 95% CI=0.35-0.59, p <0.01). Age, high comorbidity score, treatment at community facility and year diagnosis before 2009 were associated with poor OS (Table 2). Positive impact of Allo-HCT on OS was maintained in a 6-month landmark analysis after excluding patients who died or were lost follow-up within 6 months from diagnosis (HR= 0.59, 95% CI=0.45-0.77, p <0.01). Conclusion Allo-HCT is an independent prognostic factor for improved OS in CMML. [ABSTRACT FROM AUTHOR]