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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

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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.

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Acknowledgments

We thank the clinicians of the 103 institutions who entered patients into the JALSG AML 97 study and provided the data to make this study possible. We also thank Ms. Y. Wada and Ms. Y. Komatsu for data management and Ms. Y. Makino of the JALSG office for providing valuable secretarial assistance. This study was supported in part by a grant from the Ministry of Health, Labour and Welfare of Japan.

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Authors and Affiliations

  1. Division of Hematology, Tokyo Metropolitan Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan

    Hisashi Sakamaki

  2. Division of Hematology, Tokyo Metropolitan Ohtsuka Hospital, Tokyo, Japan

    Shuichi Miyawaki

  3. Department of Clinical Laboratory Science, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan

    Shigeki Ohtake

  4. Department of Hematology, Fujita Health University, Aichi, Japan

    Nobuhiko Emi

  5. Department of Internal Medicine (Hematology), Saitama Medical School, Saitama, Japan

    Fumiharu Yagasaki

  6. Department of Hematology, Dokkyo University School of Medicine, Tochigi, Japan

    Kinuko Mitani

  7. Center for Hematopoietic Disorders, Ohtanisinouchi Hospital, Kohriyama, Japan

    Shin Matsuda

  8. The First Department of Internal Medicine, Kansai Medical University, Osaka, Japan

    Yuji Kishimoto

  9. The Department of Hematology, Atomic Bomb Disease Institute, Nagasaki University School of Medicine, Nagasaki, Japan

    Yasushi Miyazaki

  10. Department of Hematology, Kumamoto University School of Medicine, Kumamoto, Japan

    Norio Asou

  11. Division of Hematology and Oncology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan

    Masatomo Takahashi

  12. Department of Hematology and Oncology, Tokai University School of Medicine, Kanagawa, Japan

    Yoshiaki Ogawa

  13. Department of Radiation Epidemiology, Atomic Bomb Disease Institute, Nagasaki University School of Medicine, Nagasaki, Japan

    Sumihisa Honda

  14. Aichi Cancer Center, Aichi, Japan

    Ryuzo Ohno

Authors
  1. Hisashi Sakamaki
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  2. Shuichi Miyawaki
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  3. Shigeki Ohtake
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  4. Nobuhiko Emi
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  5. Fumiharu Yagasaki
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  6. Kinuko Mitani
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  7. Shin Matsuda
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  8. Yuji Kishimoto
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  9. Yasushi Miyazaki
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  10. Norio Asou
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  11. Masatomo Takahashi
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  12. Yoshiaki Ogawa
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  13. Sumihisa Honda
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  14. Ryuzo Ohno
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Corresponding author

Correspondence to Hisashi Sakamaki.

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For the Japan Adult Leukemia Study Group (JALSG).

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Sakamaki, H., Miyawaki, S., Ohtake, S. et al. 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. Int J Hematol 91, 284–292 (2010). https://doi.org/10.1007/s12185-009-0483-2

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  • DOI: https://doi.org/10.1007/s12185-009-0483-2

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