Upfront allogeneic hematopoietic cell transplantation (HCT) versus remission induction chemotherapy followed by allogeneic HCT for acute myeloid leukemia with multilineage dysplasia: A propensity score matched analysis

被引：7

作者：

Konuma, Takaaki ^{[1
]}

Harada, Kaito ^{[2
]}

Yamasaki, Satoshi ^{[3
,4
]}

Mizuno, Shohei ^{[5
]}

Uchida, Naoyuki ^{[6
]}

Takahashi, Satoshi ^{[7
]}

Onizuka, Makoto ^{[2
]}

Nakamae, Hirohisa ^{[8
]}

Hidaka, Michihiro ^{[9
]}

Fukuda, Takahiro ^{[10
]}

Ohashi, Kazuteru ^{[11
]}

Kohno, Akio ^{[12
]}

Matsushita, Akiko ^{[13
]}

Kanamori, Heiwa ^{[14
]}

Ashida, Takashi ^{[15
]}

Kanda, Junya ^{[16
]}

Atsuta, Yoshiko ^{[17
,18
]}

Yano, Shingo ^{[19
]}

机构：

[1] Univ Tokyo, Inst Med Sci, Dept Hematol Oncol, Tokyo, Japan

[2] Tokai Univ, Dept Hematol & Oncol, Sch Med, Isehara, Kanagawa, Japan

[3] Natl Hosp Org Kyushu Med Ctr, Dept Hematol, Fukuoka, Fukuoka, Japan

[4] Natl Hosp Org Kyushu Med Ctr, Clin Res Inst, Fukuoka, Fukuoka, Japan

[5] Aichi Med Univ, Sch Med, Div Hematol, Dept Internal Med, Nagakute, Aichi, Japan

[6] Federat Natl Publ Serv Personnel Mutual Aid Assoc, Dept Hematol, Tokyo, Japan

[7] Univ Tokyo, Inst Med Sci, Div Mol Therapy, Adv Clin Res Ctr, Tokyo, Japan

[8] Osaka City Univ, Grad Sch Med, Hematol, Osaka, Japan

[9] Natl Hosp Org Kumamoto Med Ctr, Dept Hematol, Kumamoto, Japan

[10] Natl Canc Ctr, Dept Hematopoiet Stem Cell Transplantat, Tokyo, Japan

[11] Tokyo Metropolitan Canc & Infect Dis Ctr, Hematol Div, Tokyo, Japan

[12] JA Aichi Konan Kosei Hosp, Dept Hematol & Oncol, Konan, Japan

[13] Kobe City Hosp Org Kobe City Med Ctr Gen Hosp, Dept Hematol, Kobe, Hyogo, Japan

[14] Kanagawa Canc Ctr, Dept Hematol, Yokohama, Kanagawa, Japan

[15] Kindai Univ, Dept Hematol & Rheumatol, Fac Med, Osaka, Japan

[16] Kyoto Univ, Grad Sch Med, Dept Hematol & Oncol, Kyoto, Japan

[17] Japanese Data Ctr Hematopoiet Cell Transplantat, Nagoya, Aichi, Japan

[18] Nagoya Univ, Grad Sch Med, Dept Healthcare Adm, Nagoya, Aichi, Japan

[19] Jikei Univ, Sch Med, Dept Internal Med, Div Clin Oncol & Hematol, Tokyo, Japan

来源：

AMERICAN JOURNAL OF HEMATOLOGY | 2019年 / 94卷 / 01期

关键词：

MYELODYSPLASIA-RELATED CHANGES; INDEPENDENT PROGNOSTIC RELEVANCE; CORD-BLOOD TRANSPLANTATION; CYTOGENETIC ABNORMALITIES; REDUCED-INTENSITY; CLONAL EVOLUTION; ADULT PATIENTS; TRUMP DATA; CLASSIFICATION; AML;

D O I：

10.1002/ajh.25336

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The efficacy of induction chemotherapy before allogeneic hematopoietic cell transplantation (HCT) for patients with acute myeloid leukemia with multilineage dysplasia (AML-MLD) is unclear. Some patients with AML-MLD have received upfront HCT without prior induction chemotherapy. To compare the transplant outcomes between patients who received upfront HCT and those who received induction chemotherapy followed by allogeneic HCT for AML-MLD, we retrospectively analyzed the Japanese registration data of 1445 adult patients who had received allogeneic HCT between 2007 and 2016. Propensity score matching identified 269 patients in each cohort. There were no significant differences in overall survival between the two groups. The cumulative incidence of leukemia-related mortality was significantly lower in patients who received upfront HCT than those who received induction chemotherapy before HCT. In the subgroup analyses, upfront HCT had a significantly reduced incidence of leukemia-related mortality among patients aged between 60 and 70 years, those with a lower white blood cell count at diagnosis (<3000/mu L), and poor cytogenetic risk, and those who received myeloablative conditioning and cord blood transplantation. Our results suggested that induction chemotherapy before HCT did not have any benefits of survival after HCT for AML-MLD. Upfront HCT contributed to the reduced incidence of leukemia-related mortality after HCT. Upfront HCT should be considered for patients with AML-MLD who are eligible for allogeneic HCT.

引用

页码：103 / 110

页数：8

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