TY - JOUR
T1 - Allogeneic hematopoietic stem cell transplantation for intermediate cytogenetic risk AML in first CR
AU - Imahashi, N.
AU - Suzuki, R.
AU - Fukuda, T.
AU - Kakihana, K.
AU - Kanamori, H.
AU - Eto, T.
AU - Mori, T.
AU - Kobayashi, N.
AU - Iwato, K.
AU - Sakura, T.
AU - Ikegame, K.
AU - M Kurokawa, Kurokawa
AU - Kondo, T.
AU - Iida, H.
AU - Sakamaki, H.
AU - Tanaka, J.
AU - Kawa, K.
AU - Morishima, Y.
AU - Atsuta, Y.
AU - K Miyamura, Miyamura
N1 - Funding Information:
This study was supported by the Ministry of Health, Labor and Welfare of Japan Grant-in-Aid (KM). We thank all of the staff of the participating institutions of the Japan Society for Hematopoietic Cell Transplantation and the Japan Donor Marrow Program. We thank Dr Y Kuwatsuka for thoughtful discussion.
PY - 2013/1
Y1 - 2013/1
N2 - Allogeneic hematopoietic SCT (allo-HCT) from matched sibling donor (MSD) is recommended for younger patients with intermediate cytogenetic risk AML in first CR (CR1), whereas the role of alternative donor transplants in these patients is unknown. We retrospectively analyzed 605 patients with intermediate-risk AML, who received myeloablative allo-HCT in CR1. The 4-year OS for MSD (n=290) and matched unrelated donor (MUD; n=141) was 65% and 68% (P=0.50), respectively. In multivariate analysis, MUD had a similar risk of overall mortality as MSD (hazard ratio=0.90; 95% confidence interval, 0.62-1.30; P=0.58), whereas older age, female donor/male recipient (FDMR) combination, and requiring more than one course of induction chemotherapy to achieve CR1 were poor prognostic factors for OS. Thus, OS after MUD HCT with sex combinations other than FDMR was significantly higher than that after MSD HCT from female donors to male recipients (4-year OS 72% versus 55%, P=0.04). These results suggest that HCT, not only from MSD, but also from MUD, should be considered in younger patients with intermediate-risk AML in CR1, and that the donor-recipient sex combination is more important than the donor type in donor selection.
AB - Allogeneic hematopoietic SCT (allo-HCT) from matched sibling donor (MSD) is recommended for younger patients with intermediate cytogenetic risk AML in first CR (CR1), whereas the role of alternative donor transplants in these patients is unknown. We retrospectively analyzed 605 patients with intermediate-risk AML, who received myeloablative allo-HCT in CR1. The 4-year OS for MSD (n=290) and matched unrelated donor (MUD; n=141) was 65% and 68% (P=0.50), respectively. In multivariate analysis, MUD had a similar risk of overall mortality as MSD (hazard ratio=0.90; 95% confidence interval, 0.62-1.30; P=0.58), whereas older age, female donor/male recipient (FDMR) combination, and requiring more than one course of induction chemotherapy to achieve CR1 were poor prognostic factors for OS. Thus, OS after MUD HCT with sex combinations other than FDMR was significantly higher than that after MSD HCT from female donors to male recipients (4-year OS 72% versus 55%, P=0.04). These results suggest that HCT, not only from MSD, but also from MUD, should be considered in younger patients with intermediate-risk AML in CR1, and that the donor-recipient sex combination is more important than the donor type in donor selection.
KW - AML
KW - Allogeneic hematopoietic SCT
KW - First CR
UR - http://www.scopus.com/inward/record.url?scp=84872123279&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84872123279&partnerID=8YFLogxK
U2 - 10.1038/bmt.2012.84
DO - 10.1038/bmt.2012.84
M3 - Article
C2 - 22705800
AN - SCOPUS:84872123279
SN - 0268-3369
VL - 48
SP - 56
EP - 62
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
IS - 1
ER -