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Autologous hematopoietic cell transplantation for acute myeloid leukemia in adults: 25 years of experience in Japan

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Abstract

Autologous hematopoietic cell transplantation (HCT) has not gained universal popularity in the treatment of acute myeloid leukemia (AML), and its status remains unclear. To determine the implementation status and outcomes of autologous HCT for adults with AML in Japan, we analyzed data from 1,174 patients (including 446 with acute promyelocytic leukemia [APL]) who underwent autologous HCT between 1992 and 2016 consecutively reported to the Japanese nationwide transplantation registry. The annual number of transplantations peaked at 82 cases in 1997, and has recently remained at around 40 cases. The percentage of APL has increased sharply since 2004, and currently exceeds 70%. While most non-APL patients underwent autologous HCT during first complete remission (CR), transplantation during second CR has become mainstream for APL patients since the early 2000s. The 5-year survival, relapse, and non-relapse mortality rates were 55.3%, 42.1%, and 8.6% for non-APL patients, and 87.6%, 12.9%, and 3.4% for APL patients, respectively. Patients transplanted in the later period showed better survival than those transplanted in the earlier period, both for non-APL (P < 0.001) and APL (P = 0.036). These results clearly show the various changes in transplantation practice and post-transplant outcomes in Japan over the past 25 years.

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Acknowledgements

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 No: 18ek0510023h0002, and a grant from the Aichi Cancer Research Foundation: Grant No: 2019-8.

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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 & Shohei Mizuno

  3. Jyoban Hospital of Tokiwa Foundation, Fukushima, Japan

    Jinichi Mori

  4. Niigata Cancer Center Hospital, Niigata, Japan

    Takaaki Chou

  5. NTT Medical Center Tokyo, Tokyo, Japan

    Kensuke Usuki

  6. Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan

    Hitoji Uchiyama

  7. Nara Medical University Hospital, Kashihara, Japan

    Itsuto Amano

  8. Tokushima University Hospital, Tokushima, Japan

    Shiro Fujii

  9. Kyushu University Hospital, Fukuoka, Japan

    Toshihiro Miyamoto

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

    Takeshi Saito & Shingo Yano

  11. Harasanshin Hospital, Fukuoka, Japan

    Tomohiko Kamimura

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

    Tatsuo Ichinohe

  13. National Cancer Center Hospital, Tokyo, Japan

    Takahiro Fukuda

  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

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  1. Masamitsu Yanada
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Correspondence to Masamitsu Yanada.

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Yanada, M., Takami, A., Mizuno, S. et al. Autologous hematopoietic cell transplantation for acute myeloid leukemia in adults: 25 years of experience in Japan. Int J Hematol 111, 93–102 (2020). https://doi.org/10.1007/s12185-019-02759-y

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