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Autologous hematopoietic cell transplantation during second or subsequent complete remission of acute promyelocytic leukemia: a prognostic factor analysis

Bone Marrow Transplantation volume 57, pages 78–82 (2022)Cite this article

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Abstract

Autologous hematopoietic cell transplantation (HCT) is an effective therapy for patients with relapsed acute promyelocytic leukemia (APL). However, it remains unclear whether this procedure is equally effective for certain groups of patients. To address this question, we analyzed 296 patients with APL who had undergone autologous HCT during second or subsequent complete remission (CR2+) between 2006 and 2019. Among them, 24 patients were ≥65 years old, and 17 underwent autologous HCT during third or subsequent CR. Of the 286 patients whose measurable residual disease (MRD) data were available, 21 showed detectable MRD. The 5-year probabilities of relapse-free survival (RFS), overall survival, relapse, and nonrelapse mortality for the entire cohort were 85%, 88%, 9%, and 6%, respectively. The multivariate analysis revealed that the duration of first CR ( < or ≥2 years) was the sole factor associated with RFS (P = 0.002), but even those with CR1 duration <2 years showed a 5-year RFS of 76%. The other factors such as age, disease status, and MRD status were not predictive for the survival outcomes. Our findings demonstrate very favorable long-term results when autologous HCT is conducted during CR2 + across the various subgroups of patients with relapsed APL.

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Acknowledgements

This work was supported in part by a grant from the Practical Research Project for Allergic Diseases and Immunology (Research Technology of Medical Transplantation) from the Japan Agency for Medical Research and Development (AMED), grant number: 19ek0510023h0003, and a grant from the Aichi Cancer Research Foundation, grant number: 2021-1-9.

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Authors and Affiliations

  1. Aichi Cancer Center, Nagoya, Japan

    Masamitsu Yanada

  2. Sapporo Hokuyu Hospital, Sapporo, Japan

    Shuichi Ota

  3. Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan

    Junichi Mukae

  4. Akita University Hospital, Akita, Japan

    Miho Nara

  5. Jichi Medical University Saitama Medical Center, Saitama, Japan

    Shinichi Kako & Yoshinobu Kanda

  6. Wakayama Medical University, Wakayama, Japan

    Akinori Nishikawa

  7. Toranomon Hospital, Tokyo, Japan

    Naoyuki Uchida

  8. Anjo Kosei Hospital, Anjo, Japan

    Masashi Sawa

  9. Imamura General Hospital, Kagoshima, Japan

    Nobuaki Nakano

  10. Tokai University School of Medicine, Isehara, Japan

    Makoto Onizuka

  11. Jichi Medical University, Shimotsuke, Japan

    Yoshinobu Kanda

  12. Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan

    Tatsuo Ichinohe

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

    Yoshiko Atsuta

  14. Aichi Medical University, Nagakute, Japan

    Yoshiko Atsuta

  15. The Jikei University School of Medicine, Tokyo, Japan

    Shingo Yano

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  1. Masamitsu Yanada
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  2. Shuichi Ota
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  9. Nobuaki Nakano
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  14. Shingo Yano
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Contributions

MY designed the study, analyzed data, interpreted the results, and drafted the paper; SO, JM, MN, SK, AN, NU, MS, NN, and SY interpreted results and revised the paper; MO, YK, TI, and YA contributed to data management, interpreted the results, and revised the paper; and all authors approved the final version of the paper.

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Correspondence to Masamitsu Yanada.

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The authors declare no conflict of interest.

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Yanada, M., Ota, S., Mukae, J. et al. Autologous hematopoietic cell transplantation during second or subsequent complete remission of acute promyelocytic leukemia: a prognostic factor analysis. Bone Marrow Transplant 57, 78–82 (2022). https://doi.org/10.1038/s41409-021-01501-9

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