Comparison of Autologous and Unrelated Transplants for Cytogenetically Normal Acute Myelogenous Leukemia

Motonori Mizutani; Akiyoshi Takami; Masahiko Hara; Shohei Mizuno; Masamitsu Yanada; Takaaki Chou; Hitoji Uchiyama; Kazuteru Ohashi; Toshihiro Miyamoto; Yukiyasu Ozawa; Osamu Imataki; Naoki Kobayashi; Naoyuki Uchida; Heiwa Kanamori; Tomohiko Kamimura; Tetsuya Eto; Makoto Onizuka; Junji Tanaka; Yoshiko Atsuta; Shingo Yano

doi:10.1016/j.bbmt.2017.05.008

Comparison of Autologous and Unrelated Transplants for Cytogenetically Normal Acute Myelogenous Leukemia

Biol Blood Marrow Transplant. 2017 Sep;23(9):1447-1454. doi: 10.1016/j.bbmt.2017.05.008. Epub 2017 May 19.

Authors

Motonori Mizutani¹, Akiyoshi Takami², Masahiko Hara³, Shohei Mizuno¹, Masamitsu Yanada⁴, Takaaki Chou⁵, Hitoji Uchiyama⁶, Kazuteru Ohashi⁷, Toshihiro Miyamoto⁸, Yukiyasu Ozawa⁹, Osamu Imataki¹⁰, Naoki Kobayashi¹¹, Naoyuki Uchida¹², Heiwa Kanamori¹³, Tomohiko Kamimura¹⁴, Tetsuya Eto¹⁵, Makoto Onizuka¹⁶, Junji Tanaka¹⁷, Yoshiko Atsuta¹⁸, Shingo Yano¹⁹

Affiliations

¹ Division of Hematology, Department of Internal Medicine, School of Medicine, Aichi Medical University, Nagakute, Japan.
² Division of Hematology, Department of Internal Medicine, School of Medicine, Aichi Medical University, Nagakute, Japan. Electronic address: takami-knz@umin.ac.jp.
³ Department of Medical Innovation, Osaka University Hospital, Suita, Japan.
⁴ Department of Hematology, School of Medicine, Fujita Health University, Toyoake, Japan.
⁵ Department of Internal Medicine, Niigata Cancer Center Hospital, Niigata, Japan.
⁶ Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan.
⁷ Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
⁸ Department of Hematology and Oncology, Kyushu University Hospital, Fukuoka, Japan.
⁹ Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan.
¹⁰ Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Kagawa University Hospital, Kagawa, Japan.
¹¹ Department of Hematology, Sapporo Hokuyu Hospital, Hokkaido, Japan.
¹² Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations Toranomon Hospital, Tokyo, Japan.
¹³ Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan.
¹⁴ Department of Hematology, Harasanshin Hospital, Fukuoka, Japan.
¹⁵ Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan.
¹⁶ Department of Hematology and Oncology, Tokai University School of Medicine, Kanagawa, Japan.
¹⁷ Department of Hematology, Tokyo Women's Medical University, Tokyo, Japan.
¹⁸ Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan; Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.
¹⁹ Division of Clinical Oncology and Hematology, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan.

PMID: 28533061
DOI: 10.1016/j.bbmt.2017.05.008

Abstract

Allogeneic stem cell transplantation (SCT) from an HLA-matched sibling donor (MSD) is a postremission treatment that offers a potential cure for adults with cytogenetically normal (CN) acute myelogenous leukemia (AML) in first complete remission (CR1). The best alternative in the absence of an MSD remains unclear, however. The aim of this study was to retrospectively compare the outcomes of autologous peripheral blood stem cell transplantation (auto-PBSCT; n = 177) and allogeneic bone marrow transplantation (BMT) from an HLA-matched unrelated donor (MUD; n = 173) in adult patients with CN-AML/CR1. Both the multivariate analysis (hazard ratio [HR], 1.18; 95% confidence interval [CI], 0.71 to 1.97; P = .53) and propensity score models (HR, 1.40; 95% CI, 0.80 to 2.43; P = .24) indicated that the leukemia-free survival (LFS) rate of auto-PBSCT was not significantly different from that of MUD-BMT. These results suggest that in the absence of an available MSD, auto-PBSCT remains a viable alternative as postremission therapy in patients with CN-AML/CR1.

Keywords: Autologous peripheral blood stem cell transplantation; Leukemia-free survival; Matched unrelated donor bone marrow transplantation.

Publication types

Comparative Study

MeSH terms

Adult
Antineoplastic Agents / therapeutic use*
Bone Marrow Transplantation / methods*
Female
Humans
Karyotype
Leukemia, Myeloid, Acute / immunology
Leukemia, Myeloid, Acute / mortality
Leukemia, Myeloid, Acute / pathology
Leukemia, Myeloid, Acute / therapy*
Male
Middle Aged
Peripheral Blood Stem Cell Transplantation / methods*
Proportional Hazards Models
Remission Induction
Retrospective Studies
Siblings
Transplantation, Autologous
Transplantation, Homologous
Treatment Outcome
Unrelated Donors / statistics & numerical data*

Substances

Antineoplastic Agents