Prognostic Impact of Donor Source on Allogeneic Hematopoietic Stem Cell Transplantation Outcomes in Adults with Chronic Myelomonocytic Leukemia: A Nationwide Retrospective Analysis in Japan

Hidehiro Itonaga, Kazunari Aoki, Jun Aoki, Takayuki Ishikawa, Ken Ishiyama, Naoyuki Uchida, Toru Sakura, Kazuteru Ohashi, Mineo Kurokawa, Yukiyasu Ozawa, Ken ichi Matsuoka, Yukinori Nakamura, Fumihiko Kimura, Koji Iwato, Yuichiro Nawa, Makoto Hirokawa, Koji Kato, Tatsuo Ichinohe, Yoshiko Atsuta, Yasushi Miyazaki

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7 Citations (Scopus)

Abstract

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a curative therapeutic option for patients with chronic myelomonocytic leukemia (CMML). We retrospectively compared the post-transplantation outcomes of 159 patients with CMML who underwent allo-HSCT using 4 types of donor sources: HLA-matched related donor graft, unrelated bone marrow (U-BM), unrelated cord blood (U-CB), and HLA-mismatched related donor graft. The median patient age at allo-HSCT was 54 years (range, 16 to 75 years). In multivariate analyses, the use of HLA-matched related donor grafts correlated with better overall survival than U-BM (hazard ratio [HR], 2.05; 95% confidence interval [CI], 1.21 to 3.48; P =.008), U-CB (HR, 3.80; 95% CI, 2.07 to 6.95; P <.001), or HLA-mismatched related donor grafts (HR, 6.18; 95% CI, 2.70 to 14.15; P <.001). Mortality after the relapse or progression of CMML did not significantly differ among the 4 types of donor source. Transplantation-related mortality was highest in recipients of U-CB (HR, 3.32; 95% CI, 1.33 to 8.26; P =.010). In patients with CMML, allo-HSCT using an alternative donor may contribute to durable remission; however, further improvements in transplantation-related mortality are required for this type of transplantation.

Original languageEnglish
Pages (from-to)840-848
Number of pages9
JournalBiology of Blood and Marrow Transplantation
Volume24
Issue number4
DOIs
Publication statusPublished - Apr 2018
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Hematology
  • Transplantation

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    Itonaga, H., Aoki, K., Aoki, J., Ishikawa, T., Ishiyama, K., Uchida, N., Sakura, T., Ohashi, K., Kurokawa, M., Ozawa, Y., Matsuoka, K. I., Nakamura, Y., Kimura, F., Iwato, K., Nawa, Y., Hirokawa, M., Kato, K., Ichinohe, T., Atsuta, Y., & Miyazaki, Y. (2018). Prognostic Impact of Donor Source on Allogeneic Hematopoietic Stem Cell Transplantation Outcomes in Adults with Chronic Myelomonocytic Leukemia: A Nationwide Retrospective Analysis in Japan. Biology of Blood and Marrow Transplantation, 24(4), 840-848. https://doi.org/10.1016/j.bbmt.2017.11.016