Allo-HSCT Might Improve Long-Term Survival in Patients with CD56-Positive AML.

PURPOSE: This study aimed to evaluate whether allogeneic hematopoietic stem cell transplantation (allo-HSCT) improved long-term survival of patients with CD56-positive acute myeloid leukemia (AML). PATIENTS AND METHODS: According to predefined inclusion and exclusion criteria, 188 patients with non-M3 AML, newly diagnosed between March 1, 2017, and May 1, 2024, were enrolled in this retrospective analysis. Patients were categorized according to CD56-expression status, ELN 2022 risk stratification, and treatment choices. Clinical characteristics, remission rates, disease-free survival (DFS), overall survival (OS), and cumulative incidence of relapse (CIR) were compared between patients with CD56-positive and CD56-negative diseases. Prognostic factors were analyzed, and the prognostic impact of CD56-expression was further evaluated within transplanted and non-transplanted subgroups. RESULTS: The median follow-up time was 1102 days (interquartile range, 632-1942 days). In the CD56-positive subgroup, patients with non-transplanted had lower 3-year OS than those with allo-HSCT (22.8% vs 73.1%; P< 0.001). In the ELN 2022 adverse-risk subgroup, patients with CD56-positive disease had lower 1-year OS than those with CD56-negative disease (42.9% vs 65.3%; P = 0.035). Among the non-transplanted subgroups, patients with CD56-positive disease had similar 1-year cumulative survival (58.6% vs 64.1%, P = 0.583), but lower 3-year cumulative survival as compared with those who with CD56-negative disease (22.8% vs 32.0%, P = 0.031). Among the patients receiving allotransplants, no differences were observed in 1-year cumulative survival or 3-year cumulative survival between CD56-positive and CD56-negative patients (P = 0.969 vs P = 0.968). Multivariate analysis identified allo-HSCT (HR = 0.14, P < 0.01) and risk stratification as independent prognostic factors for CD56-positive patients. CONCLUSION: Allo-HSCT might improve long-term survival in patients with CD56-positive AML.