TY - JOUR
T1 - Clinical Benefits of Preconditioning Intervention in Patients with Relapsed or Refractory Acute Myelogenous Leukemia Who Underwent Allogeneic Hematopoietic Cell Transplantation
T2 - A Kanto Study of Group for Cell Therapy Multicenter Analysis
AU - Kanto Study Group for Cell Therapy (KSGCT)
AU - Tachibana, Takayoshi
AU - Kanda, Junya
AU - Ishizaki, Takuma
AU - Najima, Yuho
AU - Tanaka, Masatsugu
AU - Doki, Noriko
AU - Fujiwara, Shin ichiro
AU - Kimura, Shun ichi
AU - Onizuka, Makoto
AU - Takahashi, Satoshi
AU - Saito, Takeshi
AU - Mori, Takehiko
AU - Fujisawa, Shin
AU - Sakaida, Emiko
AU - Miyazaki, Takuya
AU - Aotsuka, Nobuyuki
AU - Gotoh, Moritaka
AU - Watanabe, Reiko
AU - Shono, Katsuhiro
AU - Usuki, Kensuke
AU - Tsukada, Nobuhiro
AU - Kanamori, Heiwa
AU - Kanda, Yoshinobu
AU - Okamoto, Shinichiro
N1 - Funding Information:
Conflict of interest statement: T.T. reports receiving personal fees from Otsuka, Novartis, Pfizer, BMS, Daiichi Sankyo, and Astellas. S. Fujiwara reports receiving personal fees from Astellas, Celgene, Chugai Pharma, Eisai, Kyowa Hakko Kirin, Nippon Shinyaku, Novartis, Ortho Clinical Diagnostics, Otsuka, and Pfizer. K.U. reports grants and personal fees from Astellas, Alexion, SymBio, Daiichi Sankyo, Otsuka, Novartis, Bristol-Myers Squibb, Ono, Celgene, Takeda, Nippon Shinyaku, and Kyowa Kirin; grants from AbbVie, Sumitomo Dainippon, Chugai, Janssen, Nippon Boehringer Ingelheim, Mundipharma, Astellas-Amgen-Biopharma, Apellis, Pfizer; and personal fees from Eisai, MSD, PharmaEssentia, and Yakult. The other authors have no conflicts to disclose.
Funding Information:
The authors thank all members of the KSGCT, as well as Toyohiro Kawano, Aya Nozaki, and Eri Katou at the KSGCT data center. Financial disclosure: The authors have nothing to disclose. Conflict of interest statement: T.T. reports receiving personal fees from Otsuka, Novartis, Pfizer, BMS, Daiichi Sankyo, and Astellas. S. Fujiwara reports receiving personal fees from Astellas, Celgene, Chugai Pharma, Eisai, Kyowa Hakko Kirin, Nippon Shinyaku, Novartis, Ortho Clinical Diagnostics, Otsuka, and Pfizer. K.U. reports grants and personal fees from Astellas, Alexion, SymBio, Daiichi Sankyo, Otsuka, Novartis, Bristol-Myers Squibb, Ono, Celgene, Takeda, Nippon Shinyaku, and Kyowa Kirin; grants from AbbVie, Sumitomo Dainippon, Chugai, Janssen, Nippon Boehringer Ingelheim, Mundipharma, Astellas-Amgen-Biopharma, Apellis, Pfizer; and personal fees from Eisai, MSD, PharmaEssentia, and Yakult. The other authors have no conflicts to disclose. Authorship statement: T.T. was the primary investigator, designed and managed the study, performed biomedical statistics, and wrote the manuscript. J.K. T.I. and Y.K. contributed to managing and supporting the study as the working group members of this study. Y.N. M.T. N.D. S. Fujiwara, S.K. M.O. S.T. T.S. T.M. S. Fujisawa, E.M. T.M. N.A. M.G. R.W, K.S. K.U. and N.T. contributed to collecting research forms as a representative of each institution. S.O. supervised the study. Financial disclosure: See Acknowledgments on page 14.
Publisher Copyright:
© 2020 American Society for Transplantation and Cellular Therapy
PY - 2020
Y1 - 2020
N2 - A multicenter retrospective study was conducted to evaluate the clinical significance of preconditioning intervention (PCI) before allogeneic hematopoietic cell transplantation (HCT) in patients with acute myelogenous leukemia (AML) not in remission. The study cohort consisted of 519 patients classified according to the intensity (intensive/moderate) of PCI and their response to PCI. The group treated with PCI had higher blast counts in the peripheral blood (PB) and had a lower overall survival (OS) rate (P < .001) and higher nonrelapse mortality (NRM) rate (P = .035) compared with those without PCI (no PCI group). Approximately 40% of the patients (68 of 236) achieved a good response to PCI (good PCI group), and those patients had lower blast counts in the PB compared with the group with poor response to PCI (poor PCI group). OS in the good PCI group was comparable to that in the no PCI group and significantly better than that in the poor PCI group (hazard ratio, .54; 95% confidence interval, .39 to .77; P < .001). However, OS was significantly lower in patients with intensive/moderate PCI compared with the no PCI group. These results suggest that PCI increases NRM without decreasing the post-transplantation relapse rate, but may be beneficial for patients with lower blast counts in PB irrespective of its intensity.
AB - A multicenter retrospective study was conducted to evaluate the clinical significance of preconditioning intervention (PCI) before allogeneic hematopoietic cell transplantation (HCT) in patients with acute myelogenous leukemia (AML) not in remission. The study cohort consisted of 519 patients classified according to the intensity (intensive/moderate) of PCI and their response to PCI. The group treated with PCI had higher blast counts in the peripheral blood (PB) and had a lower overall survival (OS) rate (P < .001) and higher nonrelapse mortality (NRM) rate (P = .035) compared with those without PCI (no PCI group). Approximately 40% of the patients (68 of 236) achieved a good response to PCI (good PCI group), and those patients had lower blast counts in the PB compared with the group with poor response to PCI (poor PCI group). OS in the good PCI group was comparable to that in the no PCI group and significantly better than that in the poor PCI group (hazard ratio, .54; 95% confidence interval, .39 to .77; P < .001). However, OS was significantly lower in patients with intensive/moderate PCI compared with the no PCI group. These results suggest that PCI increases NRM without decreasing the post-transplantation relapse rate, but may be beneficial for patients with lower blast counts in PB irrespective of its intensity.
KW - Acute leukemia
KW - Preconditioning intervention
KW - Refractory
KW - Relapse
UR - http://www.scopus.com/inward/record.url?scp=85094971724&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85094971724&partnerID=8YFLogxK
U2 - 10.1016/j.bbmt.2020.09.025
DO - 10.1016/j.bbmt.2020.09.025
M3 - Article
C2 - 33007494
AN - SCOPUS:85094971724
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
SN - 1083-8791
ER -