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Allografting

Allogeneic hematopoietic stem cell transplantation for intermediate cytogenetic risk AML in first CR

Bone Marrow Transplantation volume 48, pages 56–62 (2013)Cite this article

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Abstract

Allogeneic hematopoietic SCT (allo-HCT) from matched sibling donor (MSD) is recommended for younger patients with intermediate cytogenetic risk AML in first CR (CR1), whereas the role of alternative donor transplants in these patients is unknown. We retrospectively analyzed 605 patients with intermediate-risk AML, who received myeloablative allo-HCT in CR1. The 4-year OS for MSD (n=290) and matched unrelated donor (MUD; n=141) was 65% and 68% (P=0.50), respectively. In multivariate analysis, MUD had a similar risk of overall mortality as MSD (hazard ratio=0.90; 95% confidence interval, 0.62–1.30; P=0.58), whereas older age, female donor/male recipient (FDMR) combination, and requiring more than one course of induction chemotherapy to achieve CR1 were poor prognostic factors for OS. Thus, OS after MUD HCT with sex combinations other than FDMR was significantly higher than that after MSD HCT from female donors to male recipients (4-year OS 72% versus 55%, P=0.04). These results suggest that HCT, not only from MSD, but also from MUD, should be considered in younger patients with intermediate-risk AML in CR1, and that the donor–recipient sex combination is more important than the donor type in donor selection.

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Acknowledgements

This study was supported by the Ministry of Health, Labor and Welfare of Japan Grant-in-Aid (KM). We thank all of the staff of the participating institutions of the Japan Society for Hematopoietic Cell Transplantation and the Japan Donor Marrow Program. We thank Dr Y Kuwatsuka for thoughtful discussion.

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Authors and Affiliations

  1. Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan

    N Imahashi & K Miyamura

  2. Department of Hematopoietic Stem Cell Transplantation Data Management/Biostatistics, Nagoya University Graduate School of Medicine, Nagoya, Japan

    R Suzuki & Y Atsuta

  3. Department of Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan

    T Fukuda

  4. Department of Hematology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan

    K Kakihana & H Sakamaki

  5. Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan

    H Kanamori

  6. Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan

    T Eto

  7. Department of Medicine, Division of Hematology, Keio University School of Medicine, Tokyo, Japan

    T Mori

  8. Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan

    N Kobayashi

  9. Department of Hematology, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, Hiroshima, Japan

    K Iwato

  10. Department of Hematology, Saiseikai Maebashi Hospital, Gunma, Japan

    T Sakura

  11. Department of Internal Medicine, Divison of Hematology, Hyogo College of Medicine, Nishinomiya, Japan

    K Ikegame

  12. Department of Hematology and Oncology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan

    M Kurokawa

  13. Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    T Kondo

  14. Department of Hematology, Meitetsu Hospital, Nagoya, Japan

    H Iida

  15. Department of Hematology, Hokkaido University Hospital, Sapporo, Japan

    J Tanaka

  16. Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Japan

    K Kawa

  17. Department of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan

    Y Morishima

Authors
  1. N Imahashi
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  2. R Suzuki
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  3. T Fukuda
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  4. K Kakihana
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  5. H Kanamori
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  6. T Eto
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  7. T Mori
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  8. N Kobayashi
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  9. K Iwato
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  10. T Sakura
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  11. K Ikegame
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  12. M Kurokawa
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  13. T Kondo
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  14. H Iida
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  15. H Sakamaki
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  16. J Tanaka
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  17. K Kawa
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  18. Y Morishima
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  19. Y Atsuta
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  20. K Miyamura
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Correspondence to N Imahashi.

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Imahashi, N., Suzuki, R., Fukuda, T. et al. Allogeneic hematopoietic stem cell transplantation for intermediate cytogenetic risk AML in first CR. Bone Marrow Transplant 48, 56–62 (2013). https://doi.org/10.1038/bmt.2012.84

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  • DOI: https://doi.org/10.1038/bmt.2012.84

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