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01-12-2020 | Acute Myeloid Leukemia | Original Article

Effect of allogeneic HCT from unrelated donors in AML patients with intermediate- or poor-risk cytogenetics: a retrospective study from the Japanese Society for HCT

Authors: Satoshi Yamasaki, Jinichi Mori, Junya Kanda, Nobuhiko Imahashi, Naoyuki Uchida, Noriko Doki, Masatsugu Tanaka, Yuta Katayama, Tetsuya Eto, Yukiyasu Ozawa, Satoru Takada, Makoto Onizuka, Masayuki Hino, Yoshinobu Kanda, Takahiro Fukuda, Yoshiko Atsuta, Masamitsu Yanada

Published in: Annals of Hematology | Issue 12/2020

Abstract

This study aimed to analyze the factors associated with outcomes of bone marrow transplantation (UR-BMT) or cord blood stem cell transplantation from unrelated donors (UR-CBT). We assessed the time from diagnosis to transplantation among acute myeloid leukemia (AML) patients with intermediate- or poor-risk cytogenetics to identify the potential clinical efficacy of transplantation. We retrospectively analyzed 5331 patients who received UR-BMT or UR-CBT between 2008 and 2017. Patients were divided into four groups according to time from diagnosis to transplantation: (1) UR-BMT and > 5 months (n = 2353), (2) UR-BMT and ≤ 5 months (n = 379), (3) UR-CBT and > 5 months (n = 1494), and (4) UR-CBT and ≤ 5 months (n = 1106). There was no difference in overall survival (OS) for transplantation at ≤5 months and > 5 months in patients with first complete remission for both UR-BMT and UR-CBT, but OS in patients with primary induction failure (PIF) and transplantation at ≤ 5 months was significantly higher in the UR-CBT group compared with that at >5 months (P < 0.001). Multivariate Cox regression analysis also showed that transplantation at >5 months in patients with PIF was an independent predictor of poorer OS. Therefore, UR-CBT at ≤ 5 months after diagnosis is an alternative option for AML patients with PIF.

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Tiercy JM (2016) How to select the best available related or unrelated donor of hematopoietic stem cells? Haematologica 101:680–687CrossRef

Yanada M, Kurosawa S, Yamaguchi T, Uchida N, Miyawaki S, Kanamori H et al (2013) Effect of related donor availability on outcome of AML in the context of related and unrelated hematopoietic cell transplantation. Bone Marrow Transplant 48:390–395CrossRef

Yanada M, Takami A, Yamasaki S, Arai Y, Konuma T, Uchida N, Najima Y, Fukuda T, Tanaka M, Ozawa Y, Ikegame K, Takanashi M, Ichinohe T, Okamoto S, Atsuta Y, Yano S (2020) Allogeneic hematopoietic cell transplantation for adults with acute myeloid leukemia conducted in Japan during the past quarter century. Ann Hematol 99:1351–1360CrossRef

Atsuta Y, Suzuki R, Yoshimi A, Gondo H, Tanaka J, Hiraoka A, Kato K, Tabuchi K, Tsuchida M, Morishima Y, Mitamura M, Kawa K, Kato S, Nagamura T, Takanashi M, Kodera Y (2007) Unification of hematopoietic stem cell transplantation registries in Japan and establishment of the TRUMP system. Int J Hematol 86:269–274CrossRef

Atsuta Y (2016) Introduction of Transplant Registry Unified Management Program 2 (TRUMP2): scripts for TRUMP data analyses, part I (variables other than HLA-related data). Int J Hematol 103:3–10CrossRef

Arber DA, Orazi A, Hasserjian R, Thiele J, Borowitz MJ, Le Beau MM et al (2016) The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. Blood. 127:2391–2405CrossRef

Yanada M, Mori J, Aoki J, Harada K, Mizuno S, Uchida N et al (2017) Effect of cytogenetic risk status on outcomes for patients with acute myeloid leukemia undergoing various types of allogeneic hematopoietic cell transplantation: an analysis of 7812 patients. Leuk Lymphoma 28:1–9

National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology, Acute Myeloid Leukemia (Version 3.2020) Accessed 29 April 2020. Avairable from:https://www.nccn.org/professionals/physician_gls/pdf/aml.pdf. Accessed 31 Dec 2019

Giralt S, Ballen K, Rizzo D, Bacigalupo A, Horowitz M, Pasquini M, Sandmaier B (2009) Reducedintensity conditioning regimen workshop: defining the dose spectrum—report of a workshop convened by the center for international blood and marrow transplant research. Biol Blood Marrow Transplant 15:367–369CrossRef

10.

Przepiorka D, Weisdorf D, Martin P, Klingemann HG, Beatty P, Hows J, Thomas ED (1995) 1994 consensus conference on acute GVHD grading. Bone Marrow Transplant 15:825–828PubMed

11.

Filipovich AH, Weisdorf D, Pavletic S, Socie G, Wingard JR, Lee SJ, Martin P, Chien J, Przepiorka D, Couriel D, Cowen EW, Dinndorf P, Farrell A, Hartzman R, Henslee-Downey J, Jacobsohn D, McDonald G, Mittleman B, Rizzo JD, Robinson M, Schubert M, Schultz K, Shulman H, Turner M, Vogelsang G, Flowers MED (2005) National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: I. Diagnosis and staging working group report. Biol Blood Marrow Transplant 11:945–956CrossRef

12.

Holtan SG, DeFor TE, Lazaryan A, Bejanyan N, Arora M, Brunstein CG et al (2015) Composite end point of graft-versus-host disease-free, relapse-free survival after allogeneic hematopoietic cell transplantation. Blood. 125:1333–1338CrossRef

13.

Ruggeri A, Labopin M, Ciceri F, Mohty M, Nagler A (2016) Definition of GvHD-free, relapse-free survival for registry-based studies: an ALWP-EBMT analysis on patients with AML in remission. Bone Marrow Transplant 51:610–611CrossRef

14.

Fine J, Gray R (1999) A proportional hazards model for the subdistribution of a competing risk. J Am Stat Assoc 94:496–509CrossRef

15.

Sorror M, Storer B, Sandmaier BM, Maloney DG, Chauncey TR, Langston A, Maziarz RT, Pulsipher M, McSweeney PA, Storb R (2008) Hematopoietic cell transplantation-comorbidity index and Karnofsky performance status are independent predictors of morbidity and mortality after allogeneic nonmyeloablative hematopoietic cell transplantation. Cancer 112:1992–2001CrossRef

16.

Kanda Y (2013) Investigation of the freely available easy-to-use software 'EZR' for medical statistics. Bone Marrow Transplant 48:452–458CrossRef

17.

Anasetti C, Logan BR, Lee SJ, Waller EK, Weisdorf DJ, Wingard JR, Cutler CS, Westervelt P, Woolfrey A, Couban S, Ehninger G, Johnston L, Maziarz RT, Pulsipher MA, Porter DL, Mineishi S, McCarty J, Khan SP, Anderlini P, Bensinger WI, Leitman SF, Rowley SD, Bredeson C, Carter SL, Horowitz MM, Confer DL, Blood and Marrow Transplant Clinical Trials Network (2012) Peripheral-blood stem cells versus bone marrow from unrelated donors. N Engl J Med 367:1487–1496CrossRef

18.

Nagafuji K, Matsuo K, Teshima T, Mori S, Sakamaki H, Hidaka M, Ogawa H, Kodera Y, Kanda Y, Maruta A, Mori T, Yoshiba F, Ichinohe T, Kasai M, Takatsuka Y, Kubo K, Sao H, Atsuta Y, Suzuki R, Yoshida T, Tsuchida M, Harada M (2010) Peripheral blood stem cell versus bone marrow transplantation from HLA-identical sibling donors in patients with leukemia: a propensity score-based comparison from the Japan Society for Hematopoietic Stem Cell Transplantation registry. Int J Hematol 91:855–864CrossRef

19.

Barker J, Krepski TP, DeFor T, Davies SM, Wagner JE, Weisdorf DJ (2002) Searching for unrelated donor hematopoietic stem cells. Biol Blood Marrow Transplant. 8:257–260CrossRef

20.

Kanda J, Atsuta Y, Wake A, Ichinohe T, Takanashi M, Morishima Y, Taniguchi S, Takahashi S, Ogawa H, Ohashi K, Ohno Y, Aotsuka N, Onishi Y, Kato K, Nagamura-Inoue T, Kanda Y, HLA Working Group of the Japan Society for Hematopoietic Cell Transplantation (2013) Impact of the direction of HLA mismatch on transplantation outcomes in single unrelated cord blood transplantation. Biol Blood Marrow Transplant. 19:247–254CrossRef

21.

Terakura S, Atsuta Y, Tsukada N, Kobayashi T, Tanaka M, Kanda J, Najima Y, Fukuda T, Uchida N, Takahashi S, Nagamura-Inoue T, Morishima Y, Miyamura K, Japan Society for Hematopoietic Cell Transplantation (2016) Comparison of outcomes of 8/8 and 7/8 allele-matched unrelated bone marrow transplantation and single-unit cord blood transplantation in adults with acute leukemia. Biol Blood Marrow Transplant 22:330–338CrossRef

22.

Yanada M, Kanda J, Ohtake S, Fukuda T, Sakamaki H, Miyamura K, Miyawaki S, Uchida N, Maeda T, Nagamura-Inoue T, Asou N, Morishima Y, Atsuta Y, Miyazaki Y, Kimura F, Kobayashi Y, Takami A, Naoe T, Kanda Y (2016) Unrelated bone marrow transplantation or immediate umbilical cord blood transplantation for patients with acute myeloid leukemia in first complete remission. Eur J Haematol 97:278–287CrossRef

23.

Takami A, Yano S, Yokoyama H, Kuwatsuka Y, Yamaguchi T, Kanda Y, Morishima Y, Fukuda T, Miyazaki Y, Nakamae H, Tanaka J, Atsuta Y, Kanamori H (2014) Donor lymphocyte infusion for the treatment of relapsed acute myeloid leukemia after allogeneic hematopoietic stem cell transplantation: a retrospective analysis by the Adult Acute Myeloid Leukemia Working Group of the Japan Society for Hematopoietic Cell Transplantation. Biol Blood Marrow Transplant. 20:1785–1790CrossRef

24.

Hiwarkar P, Qasim W, Ricciardelli I, Gilmour K, Quezada S, Saudemont A, Amrolia P, Veys P (2015) Cord blood T cells mediate enhanced antitumor effects compared with adult peripheral blood T cells. Blood. 126:2882–2891CrossRef

25.

Milano F, Gooley T, Wood B, Woolfrey A, Flowers ME, Doney K, Witherspoon R, Mielcarek M, Deeg JH, Sorror M, Dahlberg A, Sandmaier BM, Salit R, Petersdorf E, Appelbaum FR, Delaney C (2016) Cord-blood transplantation in patients with minimal residual disease. N Engl J Med 375:944–953CrossRef

26.

Terakura S, Wake A, Inamoto Y, Murata M, Sakai R, Yamaguchi T et al (2017) Exploratory research for optimal GvHD prophylaxis after single unit CBT in adults: short-term methotrexate reduced the incidence of severe GvHD more than mycophenolate mofetil. Bone Marrow Transplant 52:423–430CrossRef

27.

Terakura S, Kuwatsuka Y, Yamasaki S, Wake A, Kanda J, Inamoto Y et al (2017) GvHD prophylaxis after single-unit reduced intensity conditioning cord blood transplantation in adults with acute leukemia. Bone Marrow Transplant 52:1261–1267CrossRef

28.

Kanda J, Morishima Y, Terakura S, Wake A, Uchida N, Takahashi S et al (2017) Impact of graft-versus-host disease on outcomes after unrelated cord blood transplantation. Leukemia. 31:663–668CrossRef

29.

Kanda J, Atsuta Y, Wake A, Ichinohe T, Takanashi M, Morishima Y et al (2013) Impact of the direction of HLA mismatch on transplantation outcomes in single unrelated cord blood transplantation. Biol Blood Marrow Transplant 19:247–254CrossRef

30.

Benjamin DK Jr, Miller WC, Bayliff S, Martel L, Alexander KA, Martin PL (2002) Infections diagnosed in the first year after pediatric stem cell transplantation. Pediatr Infect Dis J 21:227–234CrossRef

31.

Laughlin MJ, Eapen M, Rubinstein P, Wagner JE, Zhang MJ, Champlin RE, Stevens C, Barker JN, Gale RP, Lazarus HM, Marks DI, van Rood JJ, Scaradavou A, Horowitz MM (2004) Outcomes after transplantation of cord blood or bone marrow from unrelated donors in adults with leukemia. N Engl J Med 351:2265–2275CrossRef

32.

Konuma T, Kanda J, Inamoto Y, Hayashi H, Kobayashi S, Uchida N (2019) et al. Improvement of early mortality in single-unit cord blood transplantation for Japanese adults from 1998 to 2017. Am J Hematol in press

33.

Ogata M, Takano K, Moriuchi Y, Kondo T, Ueki T, Nakano N, Mori T, Uoshima N, Nagafuji K, Yamasaki S, Shibasaki Y, Sakai R, Kato K, Choi I, Jo Y, Eto T, Kako S, Oshima K, Fukuda T (2018) Effects of prophylactic foscarnet on human herpesvirus-6 reactivation and encephalitis in cord blood transplant recipients: a prospective multicenter trial with an historical control group. Biol Blood Marrow Transplant. 24:1264–1273CrossRef

34.

Yamasaki S, Hirakawa A, Aoki J, Uchida N, Fukuda T, Ogawa H, Ohashi K, Kondo T, Eto T, Kanamori H, Okumura H, Iwato K, Ichinohe T, Kanda J, Onizuka M, Kuwatsuka Y, Yanada M, Atsuta Y, Takami A, Yano S (2017) Role of reduced-intensity conditioning allogeneic hematopoietic cell transplantation in older patients with de novo acute myeloid leukemia. Ann Hematol 96:289–297CrossRef

35.

Ding L, Ley TJ, Larson DE, Miller CA, Koboldt DC, Welch JS, Ritchey JK, Young MA, Lamprecht T, McLellan MD, McMichael JF, Wallis JW, Lu C, Shen D, Harris CC, Dooling DJ, Fulton RS, Fulton LL, Chen K, Schmidt H, Kalicki-Veizer J, Magrini VJ, Cook L, McGrath SD, Vickery TL, Wendl MC, Heath S, Watson MA, Link DC, Tomasson MH, Shannon WD, Payton JE, Kulkarni S, Westervelt P, Walter MJ, Graubert TA, Mardis ER, Wilson RK, DiPersio JF (2012) Clonal evolution in relapsed acute myeloid leukaemia revealed by whole-genome sequencing. Nature. 481:506–510CrossRef

36.

Parkin B, Ouillette P, Li Y, Keller J, Lam C, Roulston D, Li C, Shedden K, Malek SN (2013) Clonal evolution and devolution after chemotherapy in adult acute myelogenous leukemia. Blood. 121:369–377CrossRef

Title: Effect of allogeneic HCT from unrelated donors in AML patients with intermediate- or poor-risk cytogenetics: a retrospective study from the Japanese Society for HCT
Authors: Satoshi Yamasaki
Jinichi Mori
Junya Kanda
Nobuhiko Imahashi
Naoyuki Uchida
Noriko Doki
Masatsugu Tanaka
Yuta Katayama
Tetsuya Eto
Yukiyasu Ozawa
Satoru Takada
Makoto Onizuka
Masayuki Hino
Yoshinobu Kanda
Takahiro Fukuda
Yoshiko Atsuta
Masamitsu Yanada
Publication date: 01-12-2020
Publisher: Springer Berlin Heidelberg
Keywords: Acute Myeloid Leukemia
Graft-Versus-Host Disease
Graft-Versus-Host Disease
Stem Cell Transplantation
Stem Cell Transplantion
Stem Cell Transplantation
Published in: Annals of Hematology / Issue 12/2020
Print ISSN: 0939-5555
Electronic ISSN: 1432-0584
DOI: https://doi.org/10.1007/s00277-020-04261-6

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