TY - JOUR
T1 - Role of autotransplantation in the treatment of acute promyelocytic leukemia patients in remission
T2 - Fukuoka BMT Group observations and a literature review
AU - Kamimura, T.
AU - Miyamoto, T.
AU - Nagafuji, K.
AU - Numata, A.
AU - Henzan, H.
AU - Takase, K.
AU - Ito, Y.
AU - Ohno, Y.
AU - Fujisaki, T.
AU - Eto, T.
AU - Takamatsu, Y.
AU - Teshima, T.
AU - Gondo, H.
AU - Akashi, K.
AU - Taniguchi, S.
AU - Harada, M.
N1 - Funding Information:
We thank the medical and nursing staff working in the Fukuoka Blood and Marrow Transplantation Group for providing patients information. This work was supported in part by a Grant-in-Aid from the Ministry of Education, Culture, Sports, Science and Technology in Japan and from the Takeda Science Foundation, Osaka, Japan to TM.
PY - 2011/6
Y1 - 2011/6
N2 - We retrospectively analyzed the outcomes of 26 patients with acute promyelocytic leukemia (APL) in the first CR (CR1) or second CR (CR2), who underwent autologous PBSCT (auto-PBSCT) between 1992 and 2008. All patients received all-trans retinoic acid-based induction therapy. After two courses of consolidation chemotherapy, upfront auto-PBSCT was performed in 20 patients in the CR1. Five patients had a high WBC count of more than 10 × 10 9/L (high risk), while 15 patients had a count of less than 10 × 109/L (low risk) at initial presentation. In addition, six patients, who were considered as low-risk patients at presentation, had a relapse after three cycles of consolidation and 2 years of maintenance therapy, but gained the molecular remission after re-induction and consolidation, and underwent auto-PBSCT in the CR2. In 26 recipients, engraftment was rapid and no TRM was documented. All 20 patients autotransplanted in CR1 were still in CR at a median of 133 months (73-193 months), and six patients who underwent auto-PBSCT in CR2 were also still in CR at a median of 41 months (2-187 months) without maintenance therapy. PML/RARα chimeric mRNA was undetectable in PBSC or BM samples examined before auto-PBSCT. Despite a small number of cases studied, our retrospective observations suggest that auto-PBSCT may be an effective treatment option to continue durable CR in the treatment of high-risk APL. We review previous reports and discuss the role of autotransplantation in the treatment of APL patients in CR.
AB - We retrospectively analyzed the outcomes of 26 patients with acute promyelocytic leukemia (APL) in the first CR (CR1) or second CR (CR2), who underwent autologous PBSCT (auto-PBSCT) between 1992 and 2008. All patients received all-trans retinoic acid-based induction therapy. After two courses of consolidation chemotherapy, upfront auto-PBSCT was performed in 20 patients in the CR1. Five patients had a high WBC count of more than 10 × 10 9/L (high risk), while 15 patients had a count of less than 10 × 109/L (low risk) at initial presentation. In addition, six patients, who were considered as low-risk patients at presentation, had a relapse after three cycles of consolidation and 2 years of maintenance therapy, but gained the molecular remission after re-induction and consolidation, and underwent auto-PBSCT in the CR2. In 26 recipients, engraftment was rapid and no TRM was documented. All 20 patients autotransplanted in CR1 were still in CR at a median of 133 months (73-193 months), and six patients who underwent auto-PBSCT in CR2 were also still in CR at a median of 41 months (2-187 months) without maintenance therapy. PML/RARα chimeric mRNA was undetectable in PBSC or BM samples examined before auto-PBSCT. Despite a small number of cases studied, our retrospective observations suggest that auto-PBSCT may be an effective treatment option to continue durable CR in the treatment of high-risk APL. We review previous reports and discuss the role of autotransplantation in the treatment of APL patients in CR.
UR - http://www.scopus.com/inward/record.url?scp=79958139994&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79958139994&partnerID=8YFLogxK
U2 - 10.1038/bmt.2010.207
DO - 10.1038/bmt.2010.207
M3 - Article
C2 - 20818443
AN - SCOPUS:79958139994
VL - 46
SP - 820
EP - 826
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
SN - 0268-3369
IS - 6
ER -