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Factors prognostic of eligibility for allogeneic HCT among older patients with AML-CR1 and adverse- or intermediate-risk cytogenetics

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Abstract

The introduction of reduced-intensity conditioning (RIC) regimens has made possible allogeneic hematopoietic cell transplantation (allo-HCT) in older patients with acute myeloid leukemia (AML). However, the optimal timing of allo-HCT in these patients and its relative risks and benefits when compared with chemotherapies have not been determined. This retrospective study by the Fukuoka Blood and Marrow Transplant Group compared RIC allo-HSCT with non-transplant therapies, the choice based on donor availability, in AML patients in their first complete remission (CR1). The prognostic value of various patient characteristics and disease-specific variables were investigated in 299 patients aged ≥60 years with AML in CR1. Among the 107 patients aged 60–65 years, 54 of whom received allo-HCT and 53 of whom continued chemotherapies; allo-HCT, adverse-risk group, and hematopoietic cell transplantation-comorbidity index were significant predictors of survival outcomes. Among 192 patients aged ≥66 years deemed ineligible for allo-HCT, relapse and Karnofsky performance status after induction therapy were significant predictors of survival outcomes. Findings from this study may facilitate a new standard of care for older AML patients in CR1 who are considered candidates for allo-HCT.

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Acknowledgments

We thank the patients and clinical staff for their participation in the study. The authors also acknowledge the Clinical Research Institute of Kyushu Medical Hospital for their editorial support.

Author contributions

S.Y. contributed to the study design, data analysis, and manuscript preparation; G.Y., R.O, K.A., M.H., N.H., F.A., S.K., F.M., T.T., and N.U. collected clinical data; and T.M., S.O., and K.A. reviewed the manuscript.

Conflict of interest

The authors declare that they have no conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-Ku, Fukuoka, 810-8563, Japan

    Satoshi Yamasaki & Seiichi Okamura

  2. Department of Hematology/Oncology, Kyushu University Hospital, Fukuoka, Japan

    Goichi Yoshimoto, Toshihiro Miyamoto & Koichi Akashi

  3. Department of Hematology/Oncology, Japan Community Health Care Organization Kyushu Hospital, Fukuoka, Japan

    Ryosuke Ogawa & Kenichi Aoki

  4. Department of Hematology, JR Kyushu Hospital, Kitakyushu, Japan

    Masakazu Higuchi

  5. Department of Hematology, Chihaya Hospital, Fukuoka, Japan

    Naoki Harada

  6. Department of Hematology, Koga Hospital 21, Kurume, Japan

    Fumito Arima

  7. Department of Hematology, Saga Prefectural Hospital Koseikan, Saga, Japan

    Seiji Kondo

  8. Department of Hematology, Shin-Kokura Hospital, Kitakyushu, Japan

    Fujio Matubara

  9. Department of Hematology/Oncology, Shimane University Hospital, Izumo, Japan

    Tsutomu Takahashi

  10. Department of Hematology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan

    Naokuni Uike

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  1. Satoshi Yamasaki
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  2. Goichi Yoshimoto
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  3. Ryosuke Ogawa
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  4. Kenichi Aoki
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  5. Masakazu Higuchi
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  6. Naoki Harada
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  7. Fumito Arima
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  8. Seiji Kondo
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  9. Fujio Matubara
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  10. Tsutomu Takahashi
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  11. Naokuni Uike
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  12. Toshihiro Miyamoto
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  13. Seiichi Okamura
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  14. Koichi Akashi
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for the Fukuoka Blood and Marrow Transplantation Group

Corresponding author

Correspondence to Satoshi Yamasaki.

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Yamasaki, S., Yoshimoto, G., Ogawa, R. et al. Factors prognostic of eligibility for allogeneic HCT among older patients with AML-CR1 and adverse- or intermediate-risk cytogenetics. Ann Hematol 94, 1159–1165 (2015). https://doi.org/10.1007/s00277-015-2338-7

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  • DOI: https://doi.org/10.1007/s00277-015-2338-7

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