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Propensity score matching/reweighting analysis comparing autologous and allogeneic stem cell transplantation for B-lineage acute lymphoblastic leukemia

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Abstract

We compared the outcomes of autologous stem cell transplantation (auto-SCT) with those of allogeneic stem cell transplantation (allo-SCT) from a human leukocyte antigen-matched related donor in patients with Philadelphia chromosome-negative B-lineage acute lymphoblastic leukemia (ALL). Newly diagnosed patients who underwent allo-SCT (n = 486) or auto-SCT (n = 99) after achieving first complete remission (CR) were included. Propensity score matching (PS) and an inverse probability of the treatment weighting (IPTW) analysis were applied to compensate for imbalances in baseline characteristics. The 5 years rates of overall survival (OS) among those in the PS-matched cohorts were 57% [95% confidence interval (CI) 46–67%] for those who received allo-SCT and 44% (95% CI 33–54%) for those who received auto-SCT. Multivariable, propensity score-matched, and IPTW analyses all revealed no statistically significant differences in OS between the two groups [hazard ratios (HR) 0.81, 95% CI 0.53–1.27, p = 0.36; HR 0.84, 95% CI 0.40–1.78, p = 0.65; HR 0.71, 95% CI 0.25–2.02, p = 0.53, respectively]. Prospective trials that include autologous transplantation as a treatment option are needed to examine the potential of autologous transplantation.

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References

  1. Terwilliger T, Abdul-Hay M. Acute lymphoblastic leukemia: a comprehensive review and 2017 update. Blood Cancer J. 2017;7: e577.

    Article  CAS  Google Scholar 

  2. Thomas X, Boiron JM, Huguet F, Dombret H, Bradstock K, Vey N, et al. Outcome of treatment in adults with acute lymphoblastic leukemia: analysis of the LALA-94 trials. J Clin Oncol. 2004;22:4075–86.

    Article  CAS  Google Scholar 

  3. Bassan R, Bourquin JP, De Angelo DJ, Chiaretti S. New approaches to the management of adult acute lymphoblastic leukemia. J Clin Oncol. 2018;36:3504–19.

    Article  CAS  Google Scholar 

  4. Giebel S, Labopin M, Socie G, Beelen D, Browne P, Volin L, et al. Improving results of allogeneic hematopoietic cell transplantation for adults with acute lymphoblastic leukemia in first complete remission: an analysis from the acute leukemia working party of the european society for blood and marrow transplantation. Haematologica. 2017;102:139–49.

    Article  Google Scholar 

  5. Dhedin N, Huynh A, Maury S, Tabrizi R, Beldjord K, Asnafi V, et al. Role of allogeneic stem cell transplantation in adult patients with Ph-negative acute lymphoblastic leukemia. Blood. 2015;125:2486–96.

    Article  CAS  Google Scholar 

  6. Willemze R, Labar B. Post-remission treatment for adult patients with acute lymphoblastic leukemia in first remission: is there a role for autologous stem cell transplantation? Semin Hematol. 2007;44:267–73.

    Article  Google Scholar 

  7. Giebel S, Labopin M, Potter M, Poire X, Sengeloev H, Socie G, et al. Comparable results of autologous and allogeneic haematopoietic stem cell transplantation for adults with Philadelphia-positive acute lymphoblastic leukaemia in first complete molecular remission: an analysis by the acute leukemia working party of the EBMT. Eur J Cancer. 2018;96:73–81.

    Article  Google Scholar 

  8. Hagop Kantarjian MD, Elias Jabbour MD. Incorporating immunotherapy into the treatment strategies of B-Cell adult acute lymphoblastic leukemia: the role of blinatumomab and inotuzumab ozogamicin. In: ASCO educational book. American Society of Clinical Oncology Alexandria; 2018. p. 574–8.

    Google Scholar 

  9. Kato H, Kawase T, Kako S, Mizuta S, Kurokawa M, Mori T, et al. Analysis of outcomes following autologous stem cell transplantation in adult patients with Philadelphia chromosome-negative acute lymphoblastic leukemia during first complete remission. Haematologica. 2014;99:e228–30.

    Article  Google Scholar 

  10. Atsuta Y. Introduction of Transplant Registry Unified Management Program 2 (TRUMP2): scripts for TRUMP data analyses, part I (variables other than HLA-related data). Int J Hematol. 2016;103:3–10.

    Article  Google Scholar 

  11. Rosenbaum PRRD. Constructing a control group using multivariate matched sampling methods that incorporate the propensity score. Am Stat. 1985;39:33–8.

    Google Scholar 

  12. LA Griswold ME, Mulrow C. Propensity score adjustment with multilevel data: setting your sites on decreasing selection bias. Ann Intern Med. 2010;152:393–5.

    Article  Google Scholar 

  13. Austin PC. An introduction to propensity score methods for reducing the effects of confounding in observational studies. Multivariate Behav Res. 2011;46:399–424.

    Article  Google Scholar 

  14. Takeuchi J, Kyo T, Naito K, Sao H, Takahashi M, Miyawaki S, et al. Induction therapy by frequent administration of doxorubicin with four other drugs, followed by intensive consolidation and maintenance therapy for adult acute lymphoblastic leukemia: the JALSG-ALL93 study. Leukemia. 2002;16(7):1259–66.

    Article  CAS  Google Scholar 

  15. Jinnai I, Sakura T, Tsuzuki M, Maeda Y, Usui N, Kato M, et al. Intensified consolidation therapy with dose-escalated doxorubicin did not improve the prognosis of adults with acute lymphoblastic leukemia: the JALSG-ALL97 study. Int J Hematol. 2010;92:490–502.

    Article  CAS  Google Scholar 

  16. Sakura T, Hayakawa F, Sugiura I, Murayama T, Imai K, Usui N, et al. High-dose methotrexate therapy significantly improved survival of adult acute lymphoblastic leukemia: a phase III study by JALSG. Leukemia. 2018;32:626–32.

    Article  CAS  Google Scholar 

  17. Saito H, Ito M, Kato S, Kodera Y, Okamoto S, Taniguchi S, et al. The Japan Marrow Donor Program, 25 years of experience in achieving 20,000 bone marrow transplantations: organization structure, activity, and financial basis. Bone Marrow Transplant. 2018;53:609–16.

    Article  Google Scholar 

  18. Giebel S, Stella-Holowiecka B, Krawczyk-Kulis M, Gokbuget N, Hoelzer D, Doubek M, et al. Status of minimal residual disease determines outcome of autologous hematopoietic SCT in adult ALL. Bone Marrow Transplant. 2010;45:1095–101.

    Article  CAS  Google Scholar 

  19. Inaba H, Greaves M, Mullighan CG. Acute lymphoblastic leukaemia. Lancet. 2013;381:1943–55.

    Article  Google Scholar 

  20. Gorin NC, Giebel S, Labopin M, Savani BN, Mohty M, Nagler A. Autologous stem cell transplantation for adult acute leukemia in 2015: time to rethink? Present status and future prospects. Bone Marrow Transplant. 2015;50:1495–502.

    Article  CAS  Google Scholar 

  21. Jabbour E, O’Brien S, Konopleva M, Kantarjian H. New insights into the pathophysiology and therapy of adult acute lymphoblastic leukemia. Cancer. 2015;121:2517–28.

    Article  Google Scholar 

  22. Dhedin N, Dombret H, Thomas X, Lheritier V, Boiron JM, Rigal-Huguet F, et al. Autologous stem cell transplantation in adults with acute lymphoblastic leukemia in first complete remission: analysis of the LALA-85, -87 and -94 trials. Leukemia. 2006;20:336–44.

    Article  CAS  Google Scholar 

  23. Goldstone AH, Richards SM, Lazarus HM, Tallman MS, Buck G, Fielding AK, et al. In adults with standard-risk acute lymphoblastic leukemia, the greatest benefit is achieved from a matched sibling allogeneic transplantation in first complete remission, and an autologous transplantation is less effective than conventional consolidation/maintenance chemotherapy in all patients: results of the International ALL Trial (MRC UKALL XII/ECOG E2993). Blood. 2008;111:1827–33.

    Article  CAS  Google Scholar 

  24. Ribera JM, Oriol A, Bethencourt C, Parody R, Hernández-Rivas JM, Moreno MJ, et al. Comparison of intensive chemotherapy, allogeneic or autologous stem cell transplantation as post-remission treatment for adult patients with high-risk acute lymphoblastic leukemia. Results of the PETHEMA ALL-93 trial. Haematologica. 2005;90:1346–56.

    CAS  PubMed  Google Scholar 

  25. Wetzler M, Watson D, Stock W, Koval G, Mulkey FA, Hoke EE, et al. Autologous transplantation for Philadelphia chromosome-positive acute lymphoblastic leukemia achieves outcomes like allogeneic transplantation: results of CALGB Study 10001 (Alliance). Haematologica. 2014;99:111–5.

    Article  Google Scholar 

Download references

Acknowledgements

The authors would like to thank all the physicians and staff members of the collaborating institutes of the JSCTC. The authors would also like to thank the JMDP, and the Japan Cord Blood Bank Network, who made this analysis possible. The authors wish to acknowledge with thanks the assistance of Dr. Keitaro Matsuo in the preparation of the manuscript.

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Author notes

  1. Shuichi Mizuta and Tomotaka Ugai have contributed equally to this work.

Authors and Affiliations

  1. Hematology and Immunology, Kanazawa Medical University, Uchinada, Japan

    Shuichi Mizuta

  2. Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, USA

    Tomotaka Ugai

  3. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, USA

    Tomotaka Ugai

  4. Department of Hematology and Cell Therapy, Aichi Cancer Center Hospital, Nagoya, Japan

    Harumi Kato

  5. Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan

    Noriko Doki

  6. Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan

    Shuichi Ota

  7. Department of Hematology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan

    Toshiro Kawakita

  8. Department of Hematology, Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital, Hiroshima, Japan

    Yuta Katayama

  9. Department of Cell Therapy and Transplantation Medicine, The University of Tokyo Hospital, Tokyo, Japan

    Mineo Kurokawa

  10. Hematology Osaka City University Hospital, Osaka, Japan

    Hirohisa Nakamae

  11. Clinical Oncology and Hematology, The Jikei University School of Medicine, Tokyo, Japan

    Shingo Yano

  12. Division of Hematology, Ehime Prefectural Central Hospital, Matsuyama, Japan

    Yuichiro Nawa

  13. Division of Hematology, Jichi Medical University, Shimotsuke, Japan

    Yoshinobu Kanda

  14. Hematopoietic Stem Cell Transplantation Division, National Cancer Center Hospital, Tokyo, Japan

    Takahiro Fukuda

  15. Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan

    Yoshiko Atsuta

  16. Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan

    Shinichi Kako

Authors
  1. Shuichi Mizuta
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  2. Tomotaka Ugai
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  3. Harumi Kato
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  4. Noriko Doki
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  8. Mineo Kurokawa
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  9. Hirohisa Nakamae
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  10. Shingo Yano
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  11. Yuichiro Nawa
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  12. Yoshinobu Kanda
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  13. Takahiro Fukuda
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  14. Yoshiko Atsuta
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  15. Shinichi Kako
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Correspondence to Shuichi Mizuta.

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Mizuta, S., Ugai, T., Kato, H. et al. Propensity score matching/reweighting analysis comparing autologous and allogeneic stem cell transplantation for B-lineage acute lymphoblastic leukemia. Int J Hematol 116, 393–400 (2022). https://doi.org/10.1007/s12185-022-03368-y

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  • DOI: https://doi.org/10.1007/s12185-022-03368-y

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