International Journal of Hematology

DOI: 10.1007/s12185-019-02759-y Pages: 93-102

Autologous hematopoietic cell transplantation for acute myeloid leukemia in adults: 25 years of experience in Japan

1. Aichi Cancer Center, Department of Hematology and Cell Therapy

2. Aichi Medical University School of Medicine

3. Jyoban Hospital of Tokiwa Foundation

4. Niigata Cancer Center Hospital

5. NTT Medical Center Tokyo

6. Japanese Red Cross Kyoto Daiichi Hospital

7. Nara Medical University Hospital

8. Tokushima University Hospital

9. Kyushu University Hospital

10. The Jikei University School of Medicine

11. Harasanshin Hospital

12. Hiroshima University, Research Institute for Radiation Biology and Medicine

13. National Cancer Center Hospital

14. Keio University School of Medicine

15. Japanese Data Center for Hematopoietic Cell Transplantation

16. Nagoya University Graduate School of Medicine

Correspondence to:
Masamitsu Yanada
Email: myanada@aichi-cc.jp

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Abstract

Autologous hematopoietic cell transplantation (HCT) has not gained universal popularity in the treatment of acute myeloid leukemia (AML), and its status remains unclear. To determine the implementation status and outcomes of autologous HCT for adults with AML in Japan, we analyzed data from 1,174 patients (including 446 with acute promyelocytic leukemia [APL]) who underwent autologous HCT between 1992 and 2016 consecutively reported to the Japanese nationwide transplantation registry. The annual number of transplantations peaked at 82 cases in 1997, and has recently remained at around 40 cases. The percentage of APL has increased sharply since 2004, and currently exceeds 70%. While most non-APL patients underwent autologous HCT during first complete remission (CR), transplantation during second CR has become mainstream for APL patients since the early 2000s. The 5-year survival, relapse, and non-relapse mortality rates were 55.3%, 42.1%, and 8.6% for non-APL patients, and 87.6%, 12.9%, and 3.4% for APL patients, respectively. Patients transplanted in the later period showed better survival than those transplanted in the earlier period, both for non-APL (P < 0.001) and APL (P = 0.036). These results clearly show the various changes in transplantation practice and post-transplant outcomes in Japan over the past 25 years.

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