Comparable Outcomes Between Autologous and Allogeneic Transplant for Adult Acute Myeloid Leukemia in First CR

Overview

Journal Bone Marrow Transplant

Specialty General Surgery

Date 2016 Jan 26

PMID 26808566

Citations 24

Authors

M Mizutani

M Hara

H Fujita

J Aoki

H Kanamori

K Ohashi

K Usuki

T Fukuda

T Chou

J Tanaka

Y Atsuta

A Takami

Affiliations

Soon will be listed here.

Abstract

Although allogeneic hematopoietic stem cell transplantation from an HLA-matched sibling donor (MSD) is a potentially curative post-remission treatment for adults with acute myeloid leukemia (AML) in their first CR, transplant-related morbidity and mortality remains a major drawback. We retrospectively compared the outcomes of patients who underwent autologous peripheral blood stem cell transplantation (auto-PBSCT; n=375) with those who underwent allogeneic bone marrow transplantation (allo-BMT; n=521) and allo-PBSCT (n=380) from MSDs for adults with AML/CR1, in which propensity score models were used to adjust selection biases among patients, primary physicians and institutions to overcome ambiguity in the patients' background information. Both the multivariate analysis and propensity score models indicated that the leukemia-free survival rate of auto-PBSCT was not significantly different from that of allo-BMT (hazard ratio (HR), 1.23; 95% confidence interval (CI), 0.92 to 1.66; P=0.16) and allo-PBSCT (HR, 1.13; 95% CI, 0.85-1.51; P=0.40). The current results suggest that auto-PBSCT remains a promising alternative treatment for patients with AML/CR1 in the absence of an available MSD.

Citing Articles

Comparison of autologous hematopoietic cell transplantation, matched sibling donor hematopoietic cell transplantation, and chemotherapy in patients with favorable- and intermediate-risk acute myeloid leukemia.

Wang M, Chen S, Zhang Q, Yuan L, Wang X, Zhang J Front Immunol. 2025; 15():1511057.

PMID: 39845970 PMC: 11751218. DOI: 10.3389/fimmu.2024.1511057.

Comparison of atrial fibrillation prevalence and in-hospital cardiovascular outcomes between patients undergoing allogeneic versus autologous hematopoietic stem cell transplantation: insights from the national inpatient sample.

Krishan S, Asad Z, Quiroga D, Ghazi S, Quartermaine C, Braunstein Z Sci Rep. 2024; 14(1):16829.

PMID: 39039091 PMC: 11263704. DOI: 10.1038/s41598-024-65294-9.

Auto-hematopoietic stem cell transplantation or chemotherapy? Meta-analysis of clinical choice for AML.

Ge S, Wang J, He Q, Zhu J, Liu P, Wang H Ann Hematol. 2024; 103(10):3855-3866.

PMID: 38267560 DOI: 10.1007/s00277-024-05632-z.

A pilot study of cord blood-derived natural killer cells as maintenance therapy after autologous hematopoietic stem cell transplantation.

Wu Y, Wang Y, Ji J, Kuang P, Chen X, Liu Z Ann Hematol. 2023; 102(11):3229-3237.

PMID: 37775597 DOI: 10.1007/s00277-023-05471-4.

Autologous stem cell transplantation in adult patients with intermediate-risk acute myeloid leukemia in first complete remission and no detectable minimal residual disease. A comparative retrospective study with haploidentical transplants of the....

Chen J, Labopin M, Pabst T, Zhang X, Jiang E, Tucci A Bone Marrow Transplant. 2023; 58(12):1322-1330.

PMID: 37640797 PMC: 10691968. DOI: 10.1038/s41409-023-02070-9.

References

Stein A, ODonnell M, Chai A, Schmidt G, Nademanee A, Parker P . In vivo purging with high-dose cytarabine followed by high-dose chemoradiotherapy and reinfusion of unpurged bone marrow for adult acute myelogenous leukemia in first complete remission. J Clin Oncol. 1996; 14(8):2206-16. DOI: 10.1200/JCO.1996.14.8.2206. View

Mehta J, Powles R, Singhal S, Horton C, Tait D, Milan S . Autologous bone marrow transplantation for acute myeloid leukemia in first remission: identification of modifiable prognostic factors. Bone Marrow Transplant. 1995; 16(4):499-506. View

Anasetti C, Logan B, Lee S, Waller E, Weisdorf D, Wingard J . Peripheral-blood stem cells versus bone marrow from unrelated donors. N Engl J Med. 2012; 367(16):1487-96. PMC: 3816375. DOI: 10.1056/NEJMoa1203517. View

Ohtake S, Miyawaki S, Fujita H, Kiyoi H, Shinagawa K, Usui N . Randomized study of induction therapy comparing standard-dose idarubicin with high-dose daunorubicin in adult patients with previously untreated acute myeloid leukemia: the JALSG AML201 Study. Blood. 2010; 117(8):2358-65. DOI: 10.1182/blood-2010-03-273243. View

Fernandez H, Sun Z, Litzow M, Luger S, Paietta E, Racevskis J . Autologous transplantation gives encouraging results for young adults with favorable-risk acute myeloid leukemia, but is not improved with gemtuzumab ozogamicin. Blood. 2011; 117(20):5306-13. PMC: 3109705. DOI: 10.1182/blood-2010-09-309229. View

Zittoun R, Mandelli F, Willemze R, de Witte T, Labar B, Resegotti L . 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.... N Engl J Med. 1995; 332(4):217-23. DOI: 10.1056/NEJM199501263320403. View

Giralt S, Ballen K, Rizzo D, Bacigalupo A, Horowitz M, Pasquini M . Reduced-intensity conditioning regimen workshop: defining the dose spectrum. Report of a workshop convened by the center for international blood and marrow transplant research. Biol Blood Marrow Transplant. 2009; 15(3):367-9. PMC: 3110087. DOI: 10.1016/j.bbmt.2008.12.497. View

Levi I, Grotto I, Yerushalmi R, Ben-Bassat I, Shpilberg O . Meta-analysis of autologous bone marrow transplantation versus chemotherapy in adult patients with acute myeloid leukemia in first remission. Leuk Res. 2004; 28(6):605-12. DOI: 10.1016/j.leukres.2003.10.029. View

Scrucca L, Santucci A, Aversa F . Competing risk analysis using R: an easy guide for clinicians. Bone Marrow Transplant. 2007; 40(4):381-7. DOI: 10.1038/sj.bmt.1705727. View

10.

Austin P . The performance of different propensity score methods for estimating marginal hazard ratios. Stat Med. 2012; 32(16):2837-49. PMC: 3747460. DOI: 10.1002/sim.5705. View

11.

Gondo H, Harada M, Miyamoto T, Takenaka K, Tanimoto K, Mizuno S . Autologous peripheral blood stem cell transplantation for acute myelogenous leukemia. Bone Marrow Transplant. 1997; 20(10):821-6. DOI: 10.1038/sj.bmt.1700979. View

12.

Suciu S, Mandelli F, de Witte T, Zittoun R, Gallo E, Labar B . 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/GIMEMAAML-10 trial. Blood. 2003; 102(4):1232-40. DOI: 10.1182/blood-2002-12-3714. View

13.

Joffe M, Rosenbaum P . Invited commentary: propensity scores. Am J Epidemiol. 1999; 150(4):327-33. DOI: 10.1093/oxfordjournals.aje.a010011. View

14.

Cassileth P, Harrington D, Appelbaum F, Lazarus H, Rowe J, Paietta E . 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(23):1649-56. DOI: 10.1056/NEJM199812033392301. View

15.

Nagafuji K, Matsuo K, Teshima T, Mori S, Sakamaki H, Hidaka M . Peripheral blood stem cell versus bone marrow transplantation from HLA-identical sibling donors in patients with leukemia: a propensity score-based comparison from the Japan Society for Hematopoietic Stem Cell Transplantation registry. Int J Hematol. 2010; 91(5):855-64. DOI: 10.1007/s12185-010-0581-1. View

16.

Breems D, Boogaerts M, Dekker A, van Putten W, Sonneveld P, Huijgens P . Autologous bone marrow transplantation as consolidation therapy in the treatment of adult patients under 60 years with acute myeloid leukaemia in first complete remission: a prospective randomized Dutch-Belgian Haemato-Oncology Co-operative Group.... Br J Haematol. 2004; 128(1):59-65. DOI: 10.1111/j.1365-2141.2004.05282.x. View

17.

Gooley T, Leisenring W, Crowley J, Storer B . Estimation of failure probabilities in the presence of competing risks: new representations of old estimators. Stat Med. 1999; 18(6):695-706. DOI: 10.1002/(sici)1097-0258(19990330)18:6<695::aid-sim60>3.0.co;2-o. View

18.

Yoshimoto G, Nagafuji K, Miyamoto T, Kinukawa N, Takase K, Eto T . FLT3 mutations in normal karyotype acute myeloid leukemia in first complete remission treated with autologous peripheral blood stem cell transplantation. Bone Marrow Transplant. 2005; 36(11):977-83. DOI: 10.1038/sj.bmt.1705169. View

19.

Gorin N, Labopin M, Frassoni F, Milpied N, Attal M, Blaise D . Identical outcome after autologous or allogeneic genoidentical hematopoietic stem-cell transplantation in first remission of acute myelocytic leukemia carrying inversion 16 or t(8;21): a retrospective study from the European Cooperative Group for.... J Clin Oncol. 2008; 26(19):3183-8. DOI: 10.1200/JCO.2007.15.3106. View

20.

Breems D, van Putten W, Huijgens P, Ossenkoppele G, Verhoef G, Verdonck L . Prognostic index for adult patients with acute myeloid leukemia in first relapse. J Clin Oncol. 2005; 23(9):1969-78. DOI: 10.1200/JCO.2005.06.027. View