Impact of Cytogenetics on Outcome of Stem Cell Transplantation for Acute Myeloid Leukemia in First Remission: A Large-Scale Retrospective Analysis of Data from the Japan Society for Hematopoietic Cell Transplantation

2004 ◽  
Vol 79 (5) ◽  
pp. 495-500 ◽  
Author(s):  
Hiroyasu Ogawa ◽  
Kazuhiro Ikegame ◽  
Manabu Kawakami ◽  
Satoshi Takahashi ◽  
Hisashi Sakamaki ◽  
...  
Author(s):  
S. N. Bondarenko ◽  
I. S. Moiseev ◽  
I. A. Samorodova ◽  
T. L. Gindina ◽  
M. A. Kucher ◽  
...  

The aim of the study was to compare the efficacy of allogeneic hematopoietic stem cell transplantation (alloHSCT) and chemotherapy (CT) of acute myeloid leukemia (AML) in first remission (CR1), to identify factors influencing the results. We compare the efficacy alloHSCT in CR1 (n = 70) and CT (n = 52). Patients were stratified by age, the level of leucocytes, the origin of AML, cytogenetic risk group and response to induction CT. Five-years overall and disease-free survival (OS and DFS) were higher in the group alloHSCT (67 and 65 % vs 46 and 30 % (p = 0.02 and p = 0.001)). Benefits of DFS after alloHSCT was in standard and high-risk cytogenetic groups (78 % versus 29 % (p = 0.001), and 34 % vs 17 % (p = 0.007)). The risk of relapse (RR) was 24 % in patients after alloHSCT vs. 57 % for CT (p = 0.003). Comparing the RR after alloHSCT and CT depending on the cytogenetic risk groups: standard (HR0.2(CI95 %0.07 - 0.56) p = 0.002), and high (HR0.27(CI95 %0.08-0.86) p = 0.03). Additional factors affect the RR were the origin of AML (de novo) (HR0.47 (CI95 %0.3-0.74) p = 0.001), the hyperleukocytosis (HR1.91 (CI95 %1.09 - 3.32) p = 0.02), and no remission after the first course CT (HR3.32(CI95 %1.57-7.0) p = 0.002). The efficacy of alloHSCT compared with CT is higher both in standard and high-risk cytogenetic group.


Blood ◽  
2009 ◽  
Vol 113 (9) ◽  
pp. 2096-2103 ◽  
Author(s):  
Yachiyo Kuwatsuka ◽  
Koichi Miyamura ◽  
Ritsuro Suzuki ◽  
Masaharu Kasai ◽  
Atsuo Maruta ◽  
...  

We analyzed 338 adult patients with acute myeloid leukemia (AML) with t(8;21) and inv(16) undergoing stem cell transplantation (SCT) who were registered in the Japan Society for Hematopoietic Cell Transplantation database. At 3 years, overall survival (OS) of patients with t(8;21) and inv(16) was 50% and 72%, respectively (P = .002). Although no difference was observed when restricted to allogeneic SCT in first complete remission (CR; 84% and 74%), OS of patients with t(8;21) and inv(16) undergoing allogeneic SCT in second or third CR (45% and 86% at 3 years; P = .008) was different. OS was not different between patients in first CR who received allogeneic SCT and those who received autologous SCT for both t(8;21) AML (84% vs 77%; P = .49) and inv(16) AML (74% vs 59%; P = .86). Patients with inv(16) not in CR did better after allogeneic SCT than those with t(8;21) (70% and 18%; P = .03). Patients with t(8;21) and inv(16) should be managed differently as to the application of SCT. SCT in first CR is not necessarily recommended for inv(16). For t(8;21) patients in first CR, a prospective trial is needed to clarify the significance of autologous SCT and allogeneic SCT over chemotherapy.


2000 ◽  
Vol 6 (1) ◽  
pp. 50-57 ◽  
Author(s):  
Charles A. Linker ◽  
Curt A. Ries ◽  
Lloyd E. Damon ◽  
Peter Sayre ◽  
Willis Navarro ◽  
...  

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