International Journal of Hematology

, Volume 91, Issue 2, pp 284–292

Allogeneic stem cell transplantation versus chemotherapy as post-remission therapy for intermediate or poor risk adult acute myeloid leukemia: results of the JALSG AML97 study

Authors

    • Division of HematologyTokyo Metropolitan Komagome Hospital
  • Shuichi Miyawaki
    • Division of HematologyTokyo Metropolitan Ohtsuka Hospital
  • Shigeki Ohtake
    • Department of Clinical Laboratory ScienceKanazawa University Graduate School of Medical Science
  • Nobuhiko Emi
    • Department of HematologyFujita Health University
  • Fumiharu Yagasaki
    • Department of Internal Medicine (Hematology)Saitama Medical School
  • Kinuko Mitani
    • Department of HematologyDokkyo University School of Medicine
  • Shin Matsuda
    • Center for Hematopoietic DisordersOhtanisinouchi Hospital
  • Yuji Kishimoto
    • The First Department of Internal MedicineKansai Medical University
  • Yasushi Miyazaki
    • The Department of Hematology, Atomic Bomb Disease InstituteNagasaki University School of Medicine
  • Norio Asou
    • Department of HematologyKumamoto University School of Medicine
  • Masatomo Takahashi
    • Division of Hematology and Oncology, Department of Internal MedicineSt. Marianna University School of Medicine
  • Yoshiaki Ogawa
    • Department of Hematology and OncologyTokai University School of Medicine
  • Sumihisa Honda
    • Department of Radiation Epidemiology, Atomic Bomb Disease InstituteNagasaki University School of Medicine
  • Ryuzo Ohno
    • Aichi Cancer Center
Original Article

DOI: 10.1007/s12185-009-0483-2

Cite this article as:
Sakamaki, H., Miyawaki, S., Ohtake, S. et al. Int J Hematol (2010) 91: 284. doi:10.1007/s12185-009-0483-2

Abstract

We prospectively compared allogeneic hematopoietic stem cell transplantation (allo-HSCT) with chemotherapy as a post-remission therapy in a multicenter trial (JALSG AML97) of adult patients with intermediate or poor risk acute myeloid leukemia (AML). Of 503 patients aged 15–50 years old registered between December 1997 and July 2001, 392 achieved complete remission (CR). CR patients classified in the intermediate or poor risk group using a new scoring system were tissue typed. Seventy-three with and 92 without an HLA-identical sibling were assigned to the donor and no-donor groups. Of 73 patients in the donor group, 38 (52%) received allo-HSCT during CR1 and 17 (23%) after relapse. Intention-to-treat analysis revealed that the relapse incidence was reduced in the donor group (52 vs. 77%; p = 0.008), and the disease-free survival (DFS) improved (39 vs. 19%; p = 0.016), but overall survival (OS) was not significantly different (46 vs. 29%; p = 0.088). The OS benefit was seen in the patients aged 36–50 years old (49 vs. 24%; p = 0.031), suggesting an advantage of allo-HSCT among older patients with leukemia that is more resistant to chemotherapy than that among younger patients.

Keywords

AMLAllogeneic hematopoietic stem cell transplantationPost-remission chemotherapy

Copyright information

© The Japanese Society of Hematology 2010