1. ¹Hematology Service, Hospital Universitario La Fe, Valencia, Spain
2. ²EBMT-ALWP Registry, Paris, France
3. ³Université Paris 6, Service des Maladies du Sang et de Thérapie Cellulaire, Hopital Saint-Antoine, AP-HP, Paris, France
4. ⁴Dipartimento di Biopatologia e Diagnostica per Immagini, University 'Tor Vergata', Rome, Italy
5. ⁵Dipartimento di Biotecnologie Cellulari e Ematologia, Universita 'La Sapienza', Rome, Italy
6. ⁶Department of Hematology, Ospedale San Martino, Genova, Italy
7. ⁷BMT Unit, Division of Hematology, IRCCS Policlinico San Matteo, Pavia, Italy
8. ⁸Institute of Hematology and Oncology, Hospital Clinic, Barcelona, Spain
9. ⁹Hematology Service, Hospital Universitario 'Marqués de Valdecilla', Santander, Spain
10. ¹⁰Department of Haematology, UCT Medical School, Cape Town, South Africa
11. ¹¹Department of Haematology and BMT Unit, Constantiaberg Medi-Clinic, Cape Town, South Africa
12. ¹²Institute of Hematology 'L and A Seragnoli', St Orsola University Hospital, Bologna, Italy
13. ¹³Hôpital Saint Louis, Assistance Publique des Hopitaux de Paris, Paris, France

Correspondence: Dr MA Sanz, Servicio de Hematología, Hospital Universitario La Fe, Avenida, Campanar 21, Valencia 46009, Spain. E-mail: msanz@uv.es, Miguel.Sanz@uv.es

Received 19 December 2006; Accepted 25 January 2007; Published online 26 February 2007.

Abstract

We performed a survey of the European Cooperative Group for Blood and Marrow Transplantation to analyze the outcome of 625 acute promyelocytic leukemia (APL) patients transplanted with auto- or allogeneic-hematopoietic stem cell transplantation (autoHSCT, alloHSCT) after 1993, in first (CR1) or in second complete remission (CR2). Leukemia-free survival (LFS) at 5 years in CR1 was 69% for 149 patients autografted and 68% for 144 patients allografted, whereas in CR2, LFS was 51% in 195 autoHSCT and 59% in 137 alloHSCT recipients, respectively. In the group of autoHSCT for CR1 (n=149), higher relapse incidence (RI) was associated with shorter time from diagnosis to transplant (<7.6 months); transplant-related mortality (TRM) was increased in older patients (>47 years), whereas for CR2, longer time from diagnosis to transplant (>18 months) was associated with increased LFS and decreased RI. In the alloHSCT group for CR1 (n=144), age (<33 years) was associated with increased LFS and decreased TRM and for CR2 (n=137), the use of mobilized peripheral blood stem cells was associated with decreased TRM. Female recipient, a female donor to male recipient and transplants performed before 1997 were associated with decreased RI. In conclusion, HSCT still appears to have a role in APL, especially for patients in CR2.