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Acute Leukemia

Reduced-intensity conditioning allogeneic hematopoietic cell transplantation for younger patients with acute myeloid leukemia: a registry-based study

Bone Marrow Transplantation volume 52, pages 818–824 (2017)Cite this article

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Abstract

Clinical efficacy of allogeneic hematopoietic cell transplantation (HCT) using reduced-intensity conditioning (RIC) for younger patients remains unclear. We therefore performed a retrospective registry-based study to evaluate outcomes for patients with AML aged between 16 and 49 years who underwent RIC allogeneic HCT. Patients receiving RIC (N=125) showed significantly worse survival than those receiving myeloablative conditioning (MAC; N=1,554) (47.7% for RIC and 54.2% for MAC at 4 years, P=0.047). However, the difference became marginal after adjustment for patient characteristics (P=0.080), and inclusion in the multivariate analysis of the HCT comorbidity index or the propensity score for estimating the likelihood of choosing RIC or MAC further reduced statistical significance (P=0.371 and 0.206, respectively), indicating the existence of a selection bias against RIC. Nevertheless, outcomes for our patients receiving RIC were still acceptable, so that RIC constitutes a potential therapeutic option for younger AML patients who are deemed unsuitable for MAC. Subgroup analyses showed that patients aged between 40 and 49 years as well as those in first or second CR at the time of transplantation exhibited similar outcomes regardless of whether they were treated with RIC or MAC.

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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).

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Authors and Affiliations

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

    M Yanada

  2. National Cancer Center Hospital, Tokyo, Japan

    S Kurosawa & T Fukuda

  3. Tokyo Metropolitan Komagome Hospital, Tokyo, Japan

    T Kobayashi

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

    Y Ozawa

  5. Kanagawa Cancer Center, Yokohama, Japan

    H Kanamori

  6. Sapporo Hokuyu Hospital, Sapporo, Japan

    N Kobayashi

  7. Anjo Kosei Hospital, Anjo, Japan

    M Sawa

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

    H Nakamae

  9. Toranomon Hospital, Tokyo, Japan

    N Uchida

  10. Institute of Biomedical Research and Innovation, Kobe, Japan

    H Hashimoto

  11. Akita University Graduate School of Medicine, Akita, Japan

    M Hirokawa

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

    Y Atsuta

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

    Y Atsuta

  14. Jikei University School of Medicine, Tokyo, Japan

    S Yano

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  1. M Yanada
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Correspondence to M Yanada.

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Yanada, M., Kurosawa, S., Kobayashi, T. et al. Reduced-intensity conditioning allogeneic hematopoietic cell transplantation for younger patients with acute myeloid leukemia: a registry-based study. Bone Marrow Transplant 52, 818–824 (2017). https://doi.org/10.1038/bmt.2016.358

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  • DOI: https://doi.org/10.1038/bmt.2016.358

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