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Patients with acute myeloid leukemia undergoing allogeneic hematopoietic cell transplantation: trends in survival during the past two decades

Bone Marrow Transplantation volume 54, pages 578–586 (2019)Cite this article

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Abstract

It remains unclear how specific innovations in allogeneic hematopoietic cell transplantation (HCT) attained over the past decades have contributed to improvement in transplantation outcomes. To address this question, we conducted a registry-based study of adults with acute myeloid leukemia in first or second complete remission who underwent allogeneic HCT between 1994 and 2013 from a sibling (N = 1600) or unrelated (N = 2113) donor matched at the antigen level for HLA-A, -B, and -DR. Preliminary analysis led us to focus on comparisons between the 1994–2006 and 2007–2013 periods. Significant improvement in survival was observed in the later cohort compared to the earlier cohort for unrelated HCT (P = 0.004), but not for related HCT (P = 0.767). The improvement in unrelated HCT was solely due to diminished non-relapse mortality (P = 0.001), while incidence of relapse did not change over time (P = 0.934). The percentage of patients receiving transplants from 8/8-matched unrelated donors was significantly higher in the later cohort (P < 0.001), and their survival was significantly better than that of those undergoing mismatched unrelated HCT (P = 0.022). These findings suggest that advances in HLA-typing technology have been vital for improvement in transplantation outcomes.

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Acknowledgements

This work was supported in part by the Practical Research Project for Allergic Diseases and Immunology (Research Technology of Medical Transplantation) from Japan Agency for Medical Research and Development (AMED) under the grant number 18ek0510023h0002.

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Authors and Affiliations

  1. Aichi Cancer Center, Nagoya, Japan

    Masamitsu Yanada

  2. Fujita Health University School of Medicine, Toyoake, Japan

    Masamitsu Yanada

  3. Niigata University Medical and Dental Hospital, Niigata, Japan

    Masayoshi Masuko

  4. Jyoban Hospital Tokiwa Foundation, Fukushima, Japan

    Jinichi Mori

  5. Yokohama City University Medical Center, Yokohama, Japan

    Jun Aoki

  6. Aichi Medical University, Nagakute, Japan

    Shohei Mizuno

  7. National Cancer Center Hospital, Tokyo, Japan

    Takahiro Fukuda

  8. Tokyo Metropolitan Komagome Hospital, Tokyo, Japan

    Kazuhiko Kakihana

  9. Japanese Red Cross Nagoya First Hospital, Nagoya, Japan

    Yukiyasu Ozawa

  10. Sapporo Hokuyu Hospital, Sapporo, Japan

    Shuichi Ota

  11. Kanagawa Cancer Center, Yokohama, Japan

    Heiwa Kanamori

  12. Keio University School of Medicine, Tokyo, Japan

    Takehiko Mori

  13. Graduate School of Medicine, Osaka City University, Osaka, Japan

    Hirohisa Nakamae

  14. Hamanomachi Hospital, Fukuoka, Japan

    Tetsuya Eto

  15. Hokkaido University Faculty of Medicine, Sapporo, Japan

    Souichi Shiratori

  16. Osaka University Graduate School of Medicine, Osaka, Japan

    Tetsuo Maeda

  17. Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital, Hiroshima, Japan

    Koji Iwato

  18. Hiroshima University Hospital, Hiroshima, Japan

    Tatsuo Ichinohe

  19. Jichi Medical University, Shimotsuke, Japan

    Yoshinobu Kanda

  20. Tokyo Women’s Medical University, Tokyo, Japan

    Junji Tanaka

  21. Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan

    Yoshiko Atsuta

  22. Nagoya University Graduate School of Medicine, Nagoya, Japan

    Yoshiko Atsuta

  23. Jikei University School of Medicine, Tokyo, Japan

    Shingo Yano

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  1. Masamitsu Yanada
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  2. Masayoshi Masuko
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Correspondence to Masamitsu Yanada.

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Yanada, M., Masuko, M., Mori, J. et al. Patients with acute myeloid leukemia undergoing allogeneic hematopoietic cell transplantation: trends in survival during the past two decades. Bone Marrow Transplant 54, 578–586 (2019). https://doi.org/10.1038/s41409-018-0301-7

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