Hematopoietic stem cell transplantation for acute promyelocytic leukemia in second or third complete remission: a retrospective analysis in the Nagoya Blood and Marrow Transplantation Group.
Acute promyelocytic leukemia (APL) is the most curable subtype of acute myeloid leukemia. Second complete remission (CR2) can be easily achieved with several therapeutic options even after relapse. However, the optimal strategy to treat APL in CR2 is still controversial. We retrospectively compared the outcome of autologous (auto) and allogeneic (allo) hematopoietic stem cell transplantation (HSCT) for patients with APL in CR2 or CR3. Fifteen patients received auto and 13 received allo HSCT between 1999 and 2004 at eight hospitals belonging to the Nagoya Blood and Marrow Transplantation Group. Four-year disease-free survival (DFS) and overall survival (OS) for autografted patients were 68.9 and 75.8%, whereas those for allografted patients were 46.2 (P = 0.350) and 46.2% (P = 0.185), respectively. Three autografted patients and one allografted patient relapsed, and one autografted patient and five allografted patients died without leukemia relapse. Among 14 autografted patients who were evaluated for MRD with molecular analysis, relapse occurred in one with positive MRD (n = 2) and two with negative MRD (n = 12). These data suggest that auto HSCT is very effective for APL in CR2 or CR3, and may be preferable to allo HSCT for a portion of patients. Prospective studies are required to define the role of auto HSCT in the treatment of relapsed APL.
Kohno
Akio
A
Division of Hematology and Oncology, JA Aichi Showa Hospital, 46 Nobaku, Nobaku-cho, Konan, Aichi, 483-8703, Japan. akohno@wd5.so-net.ne.jp.
Morishita
Yoshihisa
Y
Division of Hematology and Oncology, JA Aichi Showa Hospital, 46 Nobaku, Nobaku-cho, Konan, Aichi, 483-8703, Japan.
Iida
Hiroatsu
H
Department of Hematology, Meitetsu Hospital, Nagoya, Japan.
Yanada
Masamitsu
M
Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Uchida
Toshiki
T
Department of Hematology, Nagoya Daini Red Cross Hospital, Nagoya, Japan.
Hamaguchi
Motohiro
M
Department of Hematology, Clinical and Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
Sawa
Masashi
M
Department of Hematology, Anjo Kosei Hospital, Anjo, Japan.
Sugiura
Isamu
I
Department of Hematology, Toyohashi Municipal Hospital, Toyohashi, Japan.
Yamamoto
Kazuhito
K
Department of Hematology and Cell Therapy, Aichi Cancer Center Hospital, Nagoya, Japan.
Mizuta
Shuichi
S
Department of Hematology, Fujita Health University Hospital, Toyoake, Japan.
Sao
Hiroshi
H
Department of Hematology, Meitetsu Hospital, Nagoya, Japan.
Naoe
Tomoki
T
Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Miyamura
Koichi
K
Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan.
D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000628:therapy*; D012189:Retrospective Studies; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous