Long-term results of reduced-intensity conditioning allogeneic hematopoietic cell transplantation for older patients with acute myeloid leukemia: a retrospective analysis of 10-year follow-up data

Masamitsu Yanada, Takahiro Fukuda, Masatsugu Tanaka, Shuichi Ota, Takashi Toya, Takehiko Mori, Naoyuki Uchida, Yukiyasu Ozawa, Hirohisa Nakamae, Yoshinobu Kanda, Tatsuo Ichinohe, Yoshiko Atsuta, Shingo Yano

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1 Citation (Scopus)

Abstract

The long-term outcomes of allogeneic hematopoietic cell transplantation (HCT) with reduced-intensity conditioning (RIC) remain inconclusive. To address this issue, we conducted a nationwide registry-based study of patients with acute myeloid leukemia (AML) age 50 years or older who underwent allogeneic HCT in complete remission using RIC (n = 284) or myeloablative conditioning (MAC, n = 190) between 2002 and 2007. The median follow-up period for surviving patients was 10.1 years for RIC recipients and 10.4 years for MAC recipients. The 10-year probabilities of overall survival, relapse, and non-relapse mortality were 36.4%, 30.0%, and 35.7% for RIC recipients, and 39.8%, 26.3%, and 35.5% for MAC recipients, respectively. Multivariate analysis revealed that the conditioning intensity did not affect overall mortality (P = 0.184), relapse (P = 0.904), or non-relapse mortality (P = 0.387). For the 218 patients qualifying for propensity score-matched pairing (109 pairs), RIC was found to be associated with similar survival (P = 0.095) and relapse (P = 0.467), and significantly lower non-relapse mortality (P = 0.046) compared with MAC. Our results confirm the long-term efficacy of RIC allogeneic HCT for older patients with AML and mitigate concerns over an increase in late relapse.

Original languageEnglish
Pages (from-to)2008-2016
Number of pages9
JournalBone Marrow Transplantation
Volume55
Issue number10
DOIs
Publication statusPublished - 2020 Oct 1

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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