Allogeneic hematopoietic stem cell transplantation using reduced intensity conditioning regimen for patients with acute myeloid leukemia not in complete remission.

Autor: Shimomura Y; Department of Hematology, Kobe City Hospital Organization Kobe City Medical Center General Hospital, Kobe, Japan; Department of Environmental Medicine and Population Science, Graduate School of Medicine, Osaka University, Suita, Japan. Electronic address: shimomura_0119@yahoo.co.jp., Kitamura T; Department of Environmental Medicine and Population Science, Graduate School of Medicine, Osaka University, Suita, Japan., Yanada M; Department of Hematology and Oncology, Nagoya City University East Medical Center, Nagoya, Japan., Mizuno S; Division of Hematology, Department of Internal Medicine, Aichi Medical University, Nagakute, Japan., Kondo T; Department of Hematology, Kobe City Hospital Organization Kobe City Medical Center General Hospital, Kobe, Japan., Yoshihara S; Department of Hematology, Hyogo Medical University Hospital, Hyogo, Japan., Tanaka M; Department of Hematology, Kanagawa Cancer Center, Kanagawa, Japan., Inai K; Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan., Katayama Y; Department of Hematology, Hiroshima Red Cross Hospital & Atomic-bomb Survivors Hospital, Hiroshima, Japan., Onizuka M; Department of Hematology/Oncology, Tokai University School of Medicine, Isehara, Japan., Fukuda T; Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan., Nakamae H; Department of Hematology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan., Kurokawa M; Department of Cell Therapy and Transplantation Medicine, The University of Tokyo Hospital, Japan., Yano S; Clinical oncology and Hematology, The Jikei University School of Medicine, Tokyo, Japan., Nara M; Division of Hematology, Nephrology and Rheumatology, Akita University Hospital, Akita, Japan., Masuko M; Department of Hematopoietic Cell Therapy, Department of Hematology, Niigata University Medical and Dental Hospital, Niigata, Japan., Miyakoshi S; Department of Hematology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan., Eto T; Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan., Yoshimitsu M; Department of Hematology and Rheumatology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan., Ishimaru F; Japanese Red Cross Kanto-Koshinetsu Block Blood Center, Kanagawa, Japan., Kanda J; Department of Hematology, Graduate School of Medicine, Kyoto University, Kyoto, Japan., Atsuta Y; Japanese Data Center for Hematopoietic Cell Transplantation, Nagakute, Japan; Department of Registry Science for Transplant and Cellular Therapy, Aichi Medical University School of Medicine, Nagakute, Japan., Konuma T; Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
Jazyk: angličtina
Zdroj: Cytotherapy [Cytotherapy] 2024 Nov 17. Date of Electronic Publication: 2024 Nov 17.
DOI: 10.1016/j.jcyt.2024.11.012
Abstrakt: Background: Allogeneic hematopoietic stem cell transplantation (HSCT) is the only potentially curative treatment option for patients with refractory and relapsed acute myeloid leukemia (R/R AML) not in complete remission. Many studies investigating the prognosis of patients with R/R AML not in remission focused on patients who received myeloablative conditioning regimen (MAC). Conversely, reduced intensity conditioning regimen (RIC) could be a considerable conditioning regimen for some patients because of the high frequency of R/R AML in older patients who are not candidates for MAC.
Objective: This study aimed to evaluate the prognosis and identify factors associated with outcomes in patients with R/R AML who underwent allogeneic HSCT with RIC.
Study Design: This study included 707 adult patients with AML not in complete remission who had received RIC. The primary endpoint was progression-free survival (PFS), which was estimated using the Kaplan-Meier method. Prognostic factors were identified using a Cox proportional hazards model with multiple imputations using a chained equation approach.
Results: The 5-year PFS, overall survival, relapse, and nonrelapse mortality were 18.8% (95% confidence interval [CI]: 15.6-22.2), 22.0% (95% CI: 8.5-25.7), 53.6% (95% CI 49.7-57.4%) and 27.5% (95% CI: 24.0-31.2), respectively. Multivariable analysis revealed that male sex, poor performance status, karyotype risk, and blasts in the peripheral blood were significantly associated with PFS.
Conclusions: This study identified prognostic factors in patients with R/R AML not in complete remission. These results can help to develop a transplant strategy for the treatment of R/R AML.
Competing Interests: Declaration of competing interest The authors declare no competing financial interests in this study.
(Copyright © 2024 International Society for Cell & Gene Therapy. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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