International Journal of Hematology

, Volume 79, Issue 5, pp 495–500 | Cite as

Impact of Cytogenetics on Outcome of Stem Cell Transplantation for Acute Myeloid Leukemia in First Remission: A Large-Scale Retrospective Analysis of Data from the Japan Society for Hematopoietic Cell Transplantation

  • Hiroyasu Ogawa
  • Kazuhiro Ikegame
  • Manabu Kawakami
  • Satoshi Takahashi
  • Hisashi Sakamaki
  • Takahiro Karasuno
  • Hiroshi Sao
  • Yoshihisa Kodera
  • Noriyuki Hirabayashi
  • Shinichiro Okamoto
  • Mine Harada
  • Koji Iwato
  • Atsuo Maruta
  • Mitsune Tanimoto
  • Keisei Kawa


On the basis of transplantation data from the Japan Society for Hematopoietic Cell Transplantation, we retrospectively analyzed the impact of cytogenetics at diagnosis on the outcome of transplantation in 628 patients with acute myeloid leukemia who underwent autologous (n = 200), allogeneic related (n = 363), or allogenic unrelated (n = 65) stem cell transplantation (SCT) at first complete remission. For autologous SCT, patients at good cytogenetic risk had a significantly lower relapse rate (P = .017) and a significantly higher event-free survival (EFS) (P = .013) compared with those at intermediate risk. For allogeneic SCT, patients at good cytogenetic risk had a significantly lower relapse rate (P = .019) and insignificantly higher EFS (P = .093) than those at poor risk. For unrelated SCT, there was no significant difference in relapse rate or EFS between patients at good risk and those at intermediate risk. Comparison of the 3 transplantation modalities revealed that autologous SCT patients had a significantly higher incidence of relapse compared with related or unrelated SCT patients in the intermediate-risk group but not in the good-risk group. However, there were no significant differences in EFS among the 3 transplant modalities in either of these 2 risk groups. In multivariate analysis, cytogenetics was found to be an independent predictor of relapse as well as of treatment failure.

Key words

Acute myeloid leukemia Cytogenetics Autologous stem cell transplantation Allogeneic related stem cell transplantation Allogeneic unrelated stem cell transplantation 


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  1. 1.
    Hann IM, Stevens RF, Goldstone AH, et al. Randomized comparison of DAT versus ADE as induction chemotherapy in children and younger adults with acute myeloid leukemia: results of the Medical Research Council’s 10th AML Trial (MRC AML 10). Blood. 1997;89:2311–2318.Google Scholar
  2. 2.
    Mayer RJ, Davis RB, Schiffer CA, et al. Intensive postremission chemotherapy in adults with acute myeloid leukemia. Cancer and Leukemia Group B. N Engl J Med. 1994;331:896–903.CrossRefGoogle Scholar
  3. 3.
    Zittoun R, Jehn U, Fiere C, et al. Alternating repeated postremission treatment in adult acute myelogenous leukemia: a randomized phase III study (AML6) of the EORTC Leukemia Cooperative Group. Blood. 1989;73:896–906.Google Scholar
  4. 4.
    Cassileth PA, Harrington DP, Hines JD, et al. Maintenance chemotherapy prolongs remission duration in adult acute nonlymphocytic leukemia. J Clin Oncol. 1988;6:583–587.CrossRefGoogle Scholar
  5. 5.
    Burnett AK, Goldstone AH, Stevens RMF, et al. Randomized comparison of addition of autologous bone-marrow transplantation to intensive chemotherapy for acute myeloid leukaemia in first remission: results of MRC AML 10 trial. Lancet. 1998;351:700–708.CrossRefPubMedGoogle Scholar
  6. 6.
    Cassileth PA, Lynch E, Hines JD, et al. Varying intensity of postremission therapy in acute myeloid leukemia. Blood. 1992;79:1924–1930.Google Scholar
  7. 7.
    Linker CA, Ries CA, Damon LE, et al. Autologous stem cell transplantation for acute myeloid leukemia in first remission. Biol Blood Marrow Transplant. 2000;6:50–57.CrossRefPubMedGoogle Scholar
  8. 8.
    Cassileth PA, Anderson J, Lazarus HN, et al. Autologous bone marrow transplant in acute myeloid leukemia in first remission. J Clin Oncol. 1993;11:314–319.CrossRefPubMedGoogle Scholar
  9. 9.
    Zittoun RA, Mandelli F, Willemze R, et al. Autologous or allogeneic bone marrow transplantation compared with intensive chemotherapy in acute myelogenous leukemia. European Organization for Research and Treatment of Cancer (EORTC) and the Gruppo Italiano Malattie Ematologiche Maligne dell’Adulto (GIMEMA) Leukemia Cooperative Groups. N Engl J Med. 1995;332:217–223.CrossRefPubMedGoogle Scholar
  10. 10.
    Ferrant A, Labopin M, Frassoni F, et al. Karyotype in acute myeloblastic leukemia: prognostic significance for bone marrow transplantation in first remission—a European Group for Blood and Marrow Transplantation study. Blood. 1997;90:2931–2938.PubMedGoogle Scholar
  11. 11.
    Suciu S, Mandelli F, de Witte T, et al. Allogeneic compared with autologous stem cell transplantation in the treatment of patients younger than 46 years with acute myeloid leukemia (AML) in first complete remission (CR1): an intention-to-treat analysis of the EORTC/GIMEMA AML-10 trial. Blood. 2003;102:1232–1240.CrossRefPubMedGoogle Scholar
  12. 12.
    Cassileth PA, Harrington DP, Appelbaum FR, et al. Chemotherapy compared with autologous or allogeneic bone marrow transplantation in the management of acute myeloid leukemia in first remission. N Engl J Med. 1998;339:1649–1656.CrossRefPubMedGoogle Scholar
  13. 13.
    Mrózek K, Heinonen K, Bloomfield CD. Prognostic value of cytogenetic findings in adults with acute myeloid leukemia. Int J Hematol. 2000;72:261–271.PubMedGoogle Scholar
  14. 14.
    Grimwade D, Walker H, Oliver F, et al. The importance of diagnostic cytogenetics on outcome in AML: analysis of 1,612 patients entered into the MRC AML 10 trial. Blood. 1998;92:2322–2333.PubMedPubMedCentralGoogle Scholar
  15. 15.
    Keating S, Suciu S, de Witte T, et al. Prognostic factors of patients with acute myeloid leukemia (AML) allografted in first complete remission: an analysis of the EORTC-GIMEMA AML 8A trial. Bone Marrow Transplant. 1996;17:993–1001.PubMedGoogle Scholar
  16. 16.
    Chalandon Y, Barnett MJ, Horsman DE, et al. Influence of cytogenetic abnormalities on outcome after allogeneic bone marrow transplantation for acute myeloid leukemia in first complete remission. Biol Blood Marrow Transplant. 2002;8:435–443.CrossRefPubMedGoogle Scholar
  17. 17.
    Gale RP, Horowitz MM, Weiner RS, et al. Impact of cytogenetic abnormalities on outcome of bone marrow transplants in acute myelogenous leukemia in first remission. Bone Marrow Transplant. 1995;16:203–208.PubMedGoogle Scholar
  18. 18.
    Slovak ML, Kopecky KJ, Cassileth PA, et al. Karyotypic analysis predicts outcome of preremission and postremission therapy in adult acute myeloid leukemia: a Southwest Oncology Group/Eastern Cooperative Oncology Group study. Blood. 2000;96:4075–4083.PubMedGoogle Scholar
  19. 19.
    Slavin S, Nagler A, Naparstek E, et al. Nonmyeloablative stem cell transplantation and cell therapy as an alternative to conventional bone marrow transplantation with lethal cytoreduction for the treatment of malignant and nonmalignant hematologic diseases. Blood. 1998;91:756–763.Google Scholar
  20. 20.
    Knechtli CJC, Goulden NJ, Hancock JP, et al. Minimal residual disease status before allogeneic bone marrow transplantation is an important determinant of successful outcome for children and adolescents with acute lymphoblastic leukemia Blood. 1998;92:4072–4079.PubMedGoogle Scholar
  21. 21.
    Stirewalt DL, Guthrie KA, Beppu L, et al. Predictors of relapse and overall survival in Philadelphia chromosome-positive acute lymphoblastic leukemia after transplantation. Biol Blood Marrow Transplant. 2003;9:206–212.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Ogawa H, Tamaki H, Ikegame K, et al. The usefulness of monitoring WT1 gene transcripts for the prediction and management of relapse following allogeneic stem cell transplantation in acute type leukemia. Blood. 2003;101:1698–1704.CrossRefGoogle Scholar

Copyright information

© The Japanese Society of Hematology 2004

Authors and Affiliations

  • Hiroyasu Ogawa
    • 1
  • Kazuhiro Ikegame
    • 1
  • Manabu Kawakami
    • 1
  • Satoshi Takahashi
    • 2
  • Hisashi Sakamaki
    • 3
  • Takahiro Karasuno
    • 4
  • Hiroshi Sao
    • 5
  • Yoshihisa Kodera
    • 6
  • Noriyuki Hirabayashi
    • 7
  • Shinichiro Okamoto
    • 8
  • Mine Harada
    • 9
  • Koji Iwato
    • 10
  • Atsuo Maruta
    • 11
  • Mitsune Tanimoto
    • 12
  • Keisei Kawa
    • 13
  1. 1.Department of Molecular MedicineOsaka University Graduate School of MedicineOsakaJapan
  2. 2.Division of Molecular TherapyAdvanced Clinical Research Center, Institute of Medical Science, University of TokyoTokyo
  3. 3.Bone Marrow Transplantation TeamTokyo Metropolitan Komagome HospitalTokyo
  4. 4.Fifth Department of Internal MedicineOsaka Medical Center for Cancer and Cardiovascular DiseasesOsaka
  5. 5.Department of HematologyMeitetsu HospitalNagoya
  6. 6.Department of Internal MedicineJapanese Red Cross Nagoya First HospitalNagoya
  7. 7.Department of HematologyNagoya Daini Red Cross HospitalNagoya
  8. 8.Department of MedicineKeio University School of MedicineTokyo
  9. 9.Department of Medicine and Biosystemic ScienceKyushu University Graduate School of Medical SciencesFukuoka
  10. 10.Department of Internal MedicineHiroshima Red Cross Hospital and Atomic-Bomb Survivors HospitalHiroshima
  11. 11.Department of HematologyKanagawa Cancer CenterKanagawa
  12. 12.Department of HematologyOncology, and Respiratory Disease, Okayama University Graduate Schools of Medicine and DentistryOkayama
  13. 13.Department of PediatricsOsaka Medical Center and Research Institute for Maternal and Child HealthOsakaJapan

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