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Allogeneic hematopoietic cell transplantation for adults with acute myeloid leukemia conducted in Japan during the past quarter century

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Abstract

Acute myeloid leukemia (AML) represents the most common indication for allogeneic hematopoietic cell transplantation (HCT). This study aimed to address the implementation status of allogeneic HCT for adults with AML in Japan and to provide a comprehensive overview of post-transplant outcomes. For this purpose, we analyzed data of 15,186 patients undergoing allogeneic HCT between 1992 and 2016 who were consecutively reported to the Japanese nationwide transplantation registry. The constant increase in the annual number of transplantations was clearly attributable to the growth of unrelated transplantation, and umbilical cord blood transplantation currently accounts for one-third of all allogeneic HCTs. The proportion of older patients has increased steadily since 2000, approximately, in parallel with the introduction of reduced-intensity conditioning. The probability of overall survival (OS) was estimated at 41% (95% confidence interval (CI), 40–42%) for the entire cohort, 56% (95% CI, 55–57%) for patients transplanted in complete remission (CR), and 22% (95% CI, 21–23%) for those transplanted in non-CR. Multivariate analysis identified age, sex, performance status, disease status, cytogenetic risk, donor type, graft source, sex mismatch between the donor and the recipient, and year of transplantation as factors significantly associated with OS. These findings represent the real-world data in Japan, showing the changes in transplantation practice and a detailed estimation of post-transplant outcomes.

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Funding

This work was supported in part by a grant from the Practical Research Project for Allergic Diseases and Immunology (Research Technology of Medical Transplantation) from the Japan Agency for Medical Research and Development (AMED), grant number: 18ek0510023h0002, and a grant from the Aichi Cancer Research Foundation, grant number: 2019-8.

Author information

Authors and Affiliations

  1. Department of Hematology and Cell Therapy, Aichi Cancer Center, 1-1 Kanokoden, Chikusa-ku, Nagoya, 464-8681, Japan

    Masamitsu Yanada

  2. Aichi Medical University School of Medicine, Nagakute, Japan

    Akiyoshi Takami

  3. National Hospital Organization Kyusyu Medical Center, Fukuoka, Japan

    Satoshi Yamasaki

  4. Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Yasuyuki Arai

  5. The Institute of Medical Science, The University of Tokyo, Tokyo, Japan

    Takaaki Konuma

  6. Toranomon Hospital, Tokyo, Japan

    Naoyuki Uchida

  7. Tokyo Metropolitan Komagome Hospital, Tokyo, Japan

    Yuho Najima

  8. National Cancer Center Hospital, Tokyo, Japan

    Takahiro Fukuda

  9. Kanagawa Cancer Center, Yokohama, Japan

    Masatsugu Tanaka

  10. Japanese Red Cross Nagoya First Hospital, Nagoya, Japan

    Yukiyasu Ozawa

  11. Hyogo College of Medicine, Nishinomiya, Japan

    Kazuhiro Ikegame

  12. Japanese Red Cross Society, Tokyo, Japan

    Minoko Takanashi

  13. Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan

    Tatsuo Ichinohe

  14. Keio University School of Medicine, Tokyo, Japan

    Shinichiro Okamoto

  15. Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan

    Yoshiko Atsuta

  16. Nagoya University Graduate School of Medicine, Nagoya, Japan

    Yoshiko Atsuta

  17. The Jikei University School of Medicine, Tokyo, Japan

    Shingo Yano

Authors
  1. Masamitsu Yanada
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  2. Akiyoshi Takami
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  3. Satoshi Yamasaki
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  4. Yasuyuki Arai
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  5. Takaaki Konuma
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  6. Naoyuki Uchida
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  7. Yuho Najima
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  8. Takahiro Fukuda
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  9. Masatsugu Tanaka
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  10. Yukiyasu Ozawa
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  11. Kazuhiro Ikegame
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  12. Minoko Takanashi
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  13. Tatsuo Ichinohe
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  14. Shinichiro Okamoto
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  15. Yoshiko Atsuta
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  16. Shingo Yano
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Corresponding author

Correspondence to Masamitsu Yanada.

Ethics declarations

The study was approved by the institutional review board of the Aichi Cancer Center and was conducted in accordance with the Declaration of Helsinki. Informed consent was obtained from each patient.

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The authors declare that they have no conflict of interest.

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Yanada, M., Takami, A., Yamasaki, S. et al. Allogeneic hematopoietic cell transplantation for adults with acute myeloid leukemia conducted in Japan during the past quarter century. Ann Hematol 99, 1351–1360 (2020). https://doi.org/10.1007/s00277-020-04051-0

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