Role of reduced-intensity conditioning allogeneic hematopoietic cell transplantation in older patients with de novo acute myeloid leukemia

Satoshi Yamasaki, Akihiro Hirakawa, Jun Aoki, Naoyuki Uchida, Takahiro Fukuda, Hiroyasu Ogawa, Kazuteru Ohashi, Tadakazu Kondo, Tetsuya Eto, Heiwa Kanamori, Hirokazu Okumura, Koji Iwato, Tatsuo Ichinohe, Junya Kanda, Makoto Onizuka, Yachiyo Kuwatsuka, Masamitsu Yanada, Yoshiko Atsuta, Akiyoshi Takami, Shingo Yano

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)

Abstract

Reduced-intensity conditioning (RIC) regimens extend the therapeutic use of allogeneic hematopoietic cell transplantation (HCT) to older patients. The survival trend in 2325 patients aged >50 years presenting with de novo acute myeloid leukemia (AML) who underwent first reduced-intensity HCT (RIC-HCT) was assessed by retrospectively analyzing outcomes between 2000 and 2013. The annual number of RIC-HCTs in Japan was higher in the 2008–2013 period (n = 205/year [1229/6 years]) than in the 2000–2007 period (n = 137/year [1096/8 years]). Overall and disease-free survival were higher in the 2008–2013 period (P < 0.001) because of the improvement in transplant-related mortality (TRM). Survival regarding RIC-HCT for AML has improved over time, with an increased number of RIC-HCTs in patients with a Karnofsky performance status (KPS) ≥80. However, TRM remains high and the relapse rate has not improved over time. Multivariate analyses showed that a KPS ≥80 and complete remission at HCT were associated with less TRM and relapse, and better survival regardless of age ≥65 years. Accurate timing and prospective identification of patients at risk of TRM may aid the development of risk-adapted strategies for RIC-HCT in AML patients regardless of age.

Original languageEnglish
Pages (from-to)289-297
Number of pages9
JournalAnnals of Hematology
Volume96
Issue number2
DOIs
Publication statusPublished - Feb 1 2017
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Hematology

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