International Journal of Hematology

, Volume 91, Issue 2, pp 284–292 | Cite as

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

  • Hisashi Sakamaki
  • Shuichi Miyawaki
  • Shigeki Ohtake
  • Nobuhiko Emi
  • Fumiharu Yagasaki
  • Kinuko Mitani
  • Shin Matsuda
  • Yuji Kishimoto
  • Yasushi Miyazaki
  • Norio Asou
  • Masatomo Takahashi
  • Yoshiaki Ogawa
  • Sumihisa Honda
  • Ryuzo Ohno
Original Article

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

AML Allogeneic hematopoietic stem cell transplantation Post-remission chemotherapy 

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Copyright information

© The Japanese Society of Hematology 2010

Authors and Affiliations

  • Hisashi Sakamaki
    • 1
  • Shuichi Miyawaki
    • 2
  • Shigeki Ohtake
    • 3
  • Nobuhiko Emi
    • 4
  • Fumiharu Yagasaki
    • 5
  • Kinuko Mitani
    • 6
  • Shin Matsuda
    • 7
  • Yuji Kishimoto
    • 8
  • Yasushi Miyazaki
    • 9
  • Norio Asou
    • 10
  • Masatomo Takahashi
    • 11
  • Yoshiaki Ogawa
    • 12
  • Sumihisa Honda
    • 13
  • Ryuzo Ohno
    • 14
  1. 1.Division of HematologyTokyo Metropolitan Komagome HospitalTokyoJapan
  2. 2.Division of HematologyTokyo Metropolitan Ohtsuka HospitalTokyoJapan
  3. 3.Department of Clinical Laboratory ScienceKanazawa University Graduate School of Medical ScienceKanazawaJapan
  4. 4.Department of HematologyFujita Health UniversityAichiJapan
  5. 5.Department of Internal Medicine (Hematology)Saitama Medical SchoolSaitamaJapan
  6. 6.Department of HematologyDokkyo University School of MedicineTochigiJapan
  7. 7.Center for Hematopoietic DisordersOhtanisinouchi HospitalKohriyamaJapan
  8. 8.The First Department of Internal MedicineKansai Medical UniversityOsakaJapan
  9. 9.The Department of Hematology, Atomic Bomb Disease InstituteNagasaki University School of MedicineNagasakiJapan
  10. 10.Department of HematologyKumamoto University School of MedicineKumamotoJapan
  11. 11.Division of Hematology and Oncology, Department of Internal MedicineSt. Marianna University School of MedicineKawasakiJapan
  12. 12.Department of Hematology and OncologyTokai University School of MedicineKanagawaJapan
  13. 13.Department of Radiation Epidemiology, Atomic Bomb Disease InstituteNagasaki University School of MedicineNagasakiJapan
  14. 14.Aichi Cancer CenterAichiJapan

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