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

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• 作者：Satoshi Yamasaki ; Akihiro Hirakawa ; Jun Aoki ; Naoyuki Uchida…
• 关键词：Reduced ; intensity conditioning ; Allogeneic hematopoietic cell transplantation ; Acute myeloid leukemia ; Older patients
• 刊名：Annals of Hematology
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：96
• 期：2
• 页码：289-297
• 全文大小：
• 刊物类别：Medicine
• 刊物主题：Hematology; Oncology;
• 出版者：Springer Berlin Heidelberg
• ISSN：1432-0584
• 卷排序：96

文摘

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.