Time-Varying Effects of Graft Type on Outcomes for Patients with Acute Myeloid Leukemia Undergoing Allogeneic Hematopoietic Cell Transplantation

Masamitsu Yanada, Takaaki Konuma, Satoshi Yamasaki, Yachiyo Kuwatsuka, Masayoshi Masuko, Masatsugu Tanaka, Yukiyasu Ozawa, Takashi Toya, Takahiro Fukuda, Shuichi Ota, Masashi Sawa, Naoyuki Uchida, Hirohisa Nakamae, Tetsuya Eto, Junya Kanda, Minoko Takanashi, Yoshinobu Kanda, Yoshiko Atsuta, Shingo Yano

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

This study aimed to investigate time-varying effects of graft type on outcomes for patients with acute myeloid leukemia undergoing allogeneic hematopoietic cell transplant. For this purpose we analyzed 3952 patients, 720 of whom underwent matched related bone marrow transplantation (BMT), 1004 matched related peripheral blood stem cell transplantation (PBSCT), 856 matched unrelated BMT, and 1372 umbilical cord blood transplantation (UCBT) during complete remission. The 4-year relapse-free survival (RFS) rates were 59.1%, 52.8%, 59.5%, and 50.6%, respectively. Compared with related BMT, related PBSCT, unrelated BMT, and UCBT were associated with higher risk of nonrelapse mortality and unrelated BMT and UCBT with lower risk of relapse. As a result, both RFS and overall survival were comparable between related BMT and unrelated BMT but were worse for related PBSCT and UCBT than for related BMT. Adverse impact of UCBT was observed only during the early phase of transplant, whereas that of related PBSCT continued even after 2 years post-transplant. Our findings raise concerns about the increased risk of late nonrelapse mortality with the use of PBSC grafts and suggest that related BMT is preferable to related PBSCT; matched unrelated BMT is the next choice in the absence of a matched related donor.

Original languageEnglish
Pages (from-to)307-315
Number of pages9
JournalBiology of Blood and Marrow Transplantation
Volume26
Issue number2
DOIs
Publication statusPublished - Feb 2020
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Hematology
  • Transplantation

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