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

Research output: Contribution to journalArticle

2 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 1 2018

Fingerprint

Leukemia, Myelomonocytic, Chronic
Hematopoietic Stem Cell Transplantation
Japan
Tissue Donors
Transplantation
Fetal Blood
Confidence Intervals
Transplants
Mortality
Bone Marrow
Unrelated Donors
Multivariate Analysis
Recurrence
Survival

All Science Journal Classification (ASJC) codes

  • Hematology
  • Transplantation

Cite this

Prognostic Impact of Donor Source on Allogeneic Hematopoietic Stem Cell Transplantation Outcomes in Adults with Chronic Myelomonocytic Leukemia : A Nationwide Retrospective Analysis in Japan. / Itonaga, Hidehiro; Aoki, Kazunari; Aoki, Jun; Ishikawa, Takayuki; Ishiyama, Ken; Uchida, Naoyuki; Sakura, Toru; Ohashi, Kazuteru; Kurokawa, Mineo; Ozawa, Yukiyasu; Matsuoka, Ken ichi; Nakamura, Yukinori; Kimura, Fumihiko; Iwato, Koji; Nawa, Yuichiro; Hirokawa, Makoto; Kato, Koji; Ichinohe, Tatsuo; Atsuta, Yoshiko; Miyazaki, Yasushi.

In: Biology of Blood and Marrow Transplantation, Vol. 24, No. 4, 01.04.2018, p. 840-848.

Research output: Contribution to journalArticle

Itonaga, H, Aoki, K, Aoki, J, Ishikawa, T, Ishiyama, K, Uchida, N, Sakura, T, Ohashi, K, Kurokawa, M, Ozawa, Y, Matsuoka, KI, 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, vol. 24, no. 4, pp. 840-848. https://doi.org/10.1016/j.bbmt.2017.11.016
Itonaga, Hidehiro ; Aoki, Kazunari ; Aoki, Jun ; Ishikawa, Takayuki ; Ishiyama, Ken ; Uchida, Naoyuki ; Sakura, Toru ; Ohashi, Kazuteru ; Kurokawa, Mineo ; Ozawa, Yukiyasu ; Matsuoka, Ken ichi ; Nakamura, Yukinori ; Kimura, Fumihiko ; Iwato, Koji ; Nawa, Yuichiro ; Hirokawa, Makoto ; Kato, Koji ; Ichinohe, Tatsuo ; Atsuta, Yoshiko ; Miyazaki, Yasushi. / Prognostic Impact of Donor Source on Allogeneic Hematopoietic Stem Cell Transplantation Outcomes in Adults with Chronic Myelomonocytic Leukemia : A Nationwide Retrospective Analysis in Japan. In: Biology of Blood and Marrow Transplantation. 2018 ; Vol. 24, No. 4. pp. 840-848.
@article{5c70ec7ce3fc452780790a68fedf77a1,
title = "Prognostic Impact of Donor Source on Allogeneic Hematopoietic Stem Cell Transplantation Outcomes in Adults with Chronic Myelomonocytic Leukemia: A Nationwide Retrospective Analysis in Japan",
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.",
author = "Hidehiro Itonaga and Kazunari Aoki and Jun Aoki and Takayuki Ishikawa and Ken Ishiyama and Naoyuki Uchida and Toru Sakura and Kazuteru Ohashi and Mineo Kurokawa and Yukiyasu Ozawa and Matsuoka, {Ken ichi} and Yukinori Nakamura and Fumihiko Kimura and Koji Iwato and Yuichiro Nawa and Makoto Hirokawa and Koji Kato and Tatsuo Ichinohe and Yoshiko Atsuta and Yasushi Miyazaki",
year = "2018",
month = "4",
day = "1",
doi = "10.1016/j.bbmt.2017.11.016",
language = "English",
volume = "24",
pages = "840--848",
journal = "Biology of Blood and Marrow Transplantation",
issn = "1083-8791",
publisher = "Elsevier Inc.",
number = "4",

}

TY - JOUR

T1 - Prognostic Impact of Donor Source on Allogeneic Hematopoietic Stem Cell Transplantation Outcomes in Adults with Chronic Myelomonocytic Leukemia

T2 - A Nationwide Retrospective Analysis in Japan

AU - Itonaga, Hidehiro

AU - Aoki, Kazunari

AU - Aoki, Jun

AU - Ishikawa, Takayuki

AU - Ishiyama, Ken

AU - Uchida, Naoyuki

AU - Sakura, Toru

AU - Ohashi, Kazuteru

AU - Kurokawa, Mineo

AU - Ozawa, Yukiyasu

AU - Matsuoka, Ken ichi

AU - Nakamura, Yukinori

AU - Kimura, Fumihiko

AU - Iwato, Koji

AU - Nawa, Yuichiro

AU - Hirokawa, Makoto

AU - Kato, Koji

AU - Ichinohe, Tatsuo

AU - Atsuta, Yoshiko

AU - Miyazaki, Yasushi

PY - 2018/4/1

Y1 - 2018/4/1

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=85039048450&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85039048450&partnerID=8YFLogxK

U2 - 10.1016/j.bbmt.2017.11.016

DO - 10.1016/j.bbmt.2017.11.016

M3 - Article

C2 - 29196081

AN - SCOPUS:85039048450

VL - 24

SP - 840

EP - 848

JO - Biology of Blood and Marrow Transplantation

JF - Biology of Blood and Marrow Transplantation

SN - 1083-8791

IS - 4

ER -