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Autografting

Role of autotransplantation in the treatment of acute promyelocytic leukemia patients in remission: Fukuoka BMT Group observations and a literature review

Bone Marrow Transplantation volume 46, pages 820–826 (2011)Cite this article

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Abstract

We retrospectively analyzed the outcomes of 26 patients with acute promyelocytic leukemia (APL) in the first CR (CR1) or second CR (CR2), who underwent autologous PBSCT (auto-PBSCT) between 1992 and 2008. All patients received all-trans retinoic acid-based induction therapy. After two courses of consolidation chemotherapy, upfront auto-PBSCT was performed in 20 patients in the CR1. Five patients had a high WBC count of more than 10 × 109/L (high risk), while 15 patients had a count of less than 10 × 109/L (low risk) at initial presentation. In addition, six patients, who were considered as low-risk patients at presentation, had a relapse after three cycles of consolidation and 2 years of maintenance therapy, but gained the molecular remission after re-induction and consolidation, and underwent auto-PBSCT in the CR2. In 26 recipients, engraftment was rapid and no TRM was documented. All 20 patients autotransplanted in CR1 were still in CR at a median of 133 months (73–193 months), and six patients who underwent auto-PBSCT in CR2 were also still in CR at a median of 41 months (2–187 months) without maintenance therapy. PML/RARα chimeric mRNA was undetectable in PBSC or BM samples examined before auto-PBSCT. Despite a small number of cases studied, our retrospective observations suggest that auto-PBSCT may be an effective treatment option to continue durable CR in the treatment of high-risk APL. We review previous reports and discuss the role of autotransplantation in the treatment of APL patients in CR.

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Acknowledgements

We thank the medical and nursing staff working in the Fukuoka Blood and Marrow Transplantation Group for providing patients information. This work was supported in part by a Grant-in-Aid from the Ministry of Education, Culture, Sports, Science and Technology in Japan and from the Takeda Science Foundation, Osaka, Japan to TM.

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Authors and Affiliations

  1. Department of Hematology, Harasanshin Hospital, Fukuoka, Japan

    T Kamimura & Y Ito

  2. Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan

    T Miyamoto, K Nagafuji, T Teshima & K Akashi

  3. Department of Hematology, Hamanomachi General Hospital, Fukuoka, Japan

    A Numata, H Henzan, K Takase, T Eto & S Taniguchi

  4. Department of Hematology, Kitakyushu City Hospital, Fukuoka, Japan

    Y Ohno

  5. Department of Hematology, Matsuyama Red Cross Hospital, Matsuyama, Japan

    T Fujisaki

  6. Division of Medical Oncology, Department of Medicine, Hematology and Infectious Disease, Fukuoka University, Fukuoka, Japan

    Y Takamatsu

  7. Department of Hematology, Saga Prefectural Hospital Koseikan, Saga, Japan

    H Gondo

  8. Department of Hematology, Toranomon Hospital, Tokyo, Japan

    S Taniguchi

  9. Department of Internal medicine, National Ohmuta Hospital, Fukuoka, Japan

    M Harada

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  1. T Kamimura
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Correspondence to T Miyamoto.

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Kamimura, T., Miyamoto, T., Nagafuji, K. et al. Role of autotransplantation in the treatment of acute promyelocytic leukemia patients in remission: Fukuoka BMT Group observations and a literature review. Bone Marrow Transplant 46, 820–826 (2011). https://doi.org/10.1038/bmt.2010.207

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