{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T05:09:00Z","timestamp":1779167340820,"version":"3.51.4"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>Risk factors for relapse and non-relapse mortality (NRM) in the first years after allogeneic hematopoietic stem cells transplant (allo-HSCT) for acute myeloid leukemia (AML) are well known, but their correlation with long-term survivorship is unclear. This study aims to evaluate factors that impact on long-term survival after allo-HSCT in AML. We retrospectively analyzed data of 456 consecutive patients who received a first allo-HSCT in our center, regardless of conditioning intensity, GvHD prophylaxis, donor matching and HSC source. At transplant, two hundred and four patients (44%) were in CR1, 62 patients (14%) in CR&amp;gt;1, 27 (6%) in CR MRD+ and 163 patients (36%) in active disease (AD). Two-hundred and thirty-nine patients (52%) were alive 2 years after allo-HSCT. Median follow-up was 6.1 years. The 5 years OS was 63% for CR1, 38% for CR&amp;gt;1 and 25% for AD. However, in patients alive and disease free 2 years after allo-HSCT the probability of being alive for 3 more years was 86% for CR1, 72% for CR&amp;gt;1 and 79% for AD, with no statistically significant differences between CR&amp;gt;1 and AD. Other variables associated with better outcomes included younger age, more recent transplantation, and having a female donor for a male recipient. Relapse remained the main cause of death, even among long-term survivors. In conclusion, the negative impact of advanced disease at the time of allo-HSCT appears to progressively reduce after transplantation, highlighting the excellent long-term outcomes of patients who remain disease-free at 2 years after allo-HSCT, regardless of pre-transplantation disease status.<\/jats:p>","DOI":"10.3389\/fimmu.2026.1818603","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T04:22:03Z","timestamp":1779164523000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The conditional benefit of being alive and disease free at 2 years after transplant: a long term survival evaluation among 456 patients affected by acute myeloid leukemia"],"prefix":"10.3389","volume":"17","author":[{"given":"Alessandro","family":"Bruno","sequence":"first","affiliation":[{"name":"Hematology and Bone Marrow Transplantation Unit, IRCCS San Raffaele Scientific Institute","place":["Milan, 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