Allogeneic Hematopoietic Stem Cell Transplantation for Adolescents and Young Adults with Acute Myeloid Leukemia

Daisuke Tomizawa; Shiro Tanaka; Tadakazu Kondo; Yoshiko Hashii; Yasuyuki Arai; Kazuko Kudo; Takashi Taga; Takahiro Fukuda; Hiroaki Goto; Jiro Inagaki; Katsuyoshi Koh; Kazuteru Ohashi; Yukiyasu Ozawa; Masami Inoue; Koji Kato; Junji Tanaka; Yoshiko Atsuta; Souichi Adachi; Hiroyuki Ishida

doi:10.1016/j.bbmt.2017.05.009

Allogeneic Hematopoietic Stem Cell Transplantation for Adolescents and Young Adults with Acute Myeloid Leukemia

Biol Blood Marrow Transplant. 2017 Sep;23(9):1515-1522. doi: 10.1016/j.bbmt.2017.05.009. Epub 2017 May 10.

Authors

Daisuke Tomizawa¹, Shiro Tanaka², Tadakazu Kondo³, Yoshiko Hashii⁴, Yasuyuki Arai³, Kazuko Kudo⁵, Takashi Taga⁶, Takahiro Fukuda⁷, Hiroaki Goto⁸, Jiro Inagaki⁹, Katsuyoshi Koh¹⁰, Kazuteru Ohashi¹¹, Yukiyasu Ozawa¹², Masami Inoue¹³, Koji Kato¹⁴, Junji Tanaka¹⁵, Yoshiko Atsuta¹⁶, Souichi Adachi¹⁷, Hiroyuki Ishida¹⁸

Affiliations

¹ Division of Leukemia and Lymphoma, Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan. Electronic address: tomizawa-d@ncchd.go.jp.
² Department of Clinical Biostatistics, Kyoto University, Kyoto, Japan.
³ Department of Hematology and Oncology, Kyoto University, Kyoto, Japan.
⁴ Department of Pediatrics, Osaka University, Suita, Japan.
⁵ Department of Pediatrics, Fujita Health University, Toyoake, Japan.
⁶ Department of Pediatrics, Shiga University of Medical Science, Otsu, Japan.
⁷ Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan.
⁸ Division of Hemato-Oncology/Regenerative Medicine, Kanagawa Children's Medical Center, Yokohama, Japan.
⁹ Department of Pediatrics, National Kyushu Cancer Center, Fukuoka, Japan.
¹⁰ Department of Hematology/Oncology, Saitama Children's Medical Center, Saitama, Japan.
¹¹ Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
¹² Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan.
¹³ Department of Hematology/Oncology, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Japan.
¹⁴ Department of Hematology and Oncology, Children's Medical Center, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan.
¹⁵ Department of Hematology, Tokyo Women's Medical University, Tokyo, Japan.
¹⁶ Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan; Department of Healthcare Administration, Nagoya University, Nagoya, Japan.
¹⁷ Department of Human Health Sciences, Kyoto University, Kyoto, Japan.
¹⁸ Department of Pediatrics, Kyoto City Hospital, Kyoto, Japan.

PMID: 28501543
DOI: 10.1016/j.bbmt.2017.05.009

Abstract

Few reports have focused on adolescent and young adult (AYA) patients with acute myeloid leukemia (AML) treated with hematopoietic stem cell transplantation (HSCT). We performed a retrospective analysis based on data obtained from a Japanese nationwide registration database to compare HSCT outcomes in AYA patients with AML with those in children with AML. An analysis of the 2973 patients with de novo AML who received allogeneic HSCT from 1990 to 2013 showed inferior 5-year overall survival (OS) (54% versus 58%, P <.01) and increased treatment-related mortality (TRM) (16% versus 13%, P = .02) in AYA patients. Multivariate analysis for both OS and TRM showed a significant negative impact on AYAs. However, the negative impact of older age lost its significance in an additional analysis focusing on 1407 recent transplant recipients with high-resolution HLA typing (2000 to 2013). Finally, we analyzed the impact of transplantation center type on HSCT outcomes in 317 adolescent patients (15 to 18 years old) and found no difference in outcomes between patients treated at a pediatric or an adult hospital. Higher age was a strong predictive factor for inferior OS resulting from increased TRM, which can be eliminated with better donor selection using high-resolution HLA typing.

Keywords: Acute myeloid leukemia; Adolescent and young adult; Children; Hematopoietic stem cell transplantation.

MeSH terms

Adolescent
Adult
Antineoplastic Agents / therapeutic use*
Child
Child, Preschool
Donor Selection
Female
Graft vs Host Disease / immunology
Graft vs Host Disease / mortality
Graft vs Host Disease / pathology
Graft vs Host Disease / prevention & control*
Hematopoietic Stem Cell Transplantation*
Histocompatibility Testing
Humans
Infant
Leukemia, Myeloid, Acute / immunology
Leukemia, Myeloid, Acute / mortality
Leukemia, Myeloid, Acute / pathology
Leukemia, Myeloid, Acute / therapy*
Male
Prognosis
Retrospective Studies
Survival Analysis
Transplantation Conditioning / methods
Transplantation, Homologous
Treatment Outcome

Substances

Antineoplastic Agents