title: Effect of related donor availability on outcome of AML in the context of related and unrelated hematopoietic cell transplantation.
abstract: Although allogeneic hematopoietic cell transplantation (HCT) from a related donor is effective therapy for younger patients with AML, it remains unknown how the availability of a related donor affects the outcome when unrelated HCT is a treatment option for patients without a related donor. To address this issue, we retrospectively analyzed 605 cytogenetically non-favorable AML patients younger than 50 years for whom a related donor search was performed during first CR (CR1). The 4-year OS was 62% in 253 patients with a related donor and 59% in 352 patients without a related donor (P=0.534). Allogeneic HCT was performed during CR1 in 62% and 41% of patients with and without a related donor, respectively. Among patients transplanted in CR1, the cumulative incidence of non-relapse mortality was significantly higher in patients without a related donor (P=0.022), but there was no difference in post-transplant OS between the groups (P=0.262). These findings show the usefulness of unrelated HCT in younger patients with cytogenetically non-favorable AML who do not have a related donor. The extensive use of unrelated HCT for such patients may minimize the potential disadvantage of lacking a related donor.
authors.affiliation: Department of Hematology, Fujita Health University School of Medicine, Aichi, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Yanada
authors.forename: S
authors.initials: S
authors.lastname: Kurosawa
authors.forename: T
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: N
authors.initials: N
authors.lastname: Uchida
authors.forename: S
authors.initials: S
authors.lastname: Miyawaki
authors.forename: H
authors.initials: H
authors.lastname: Kanamori
authors.forename: K
authors.initials: K
authors.lastname: Usuki
authors.forename: T
authors.initials: T
authors.lastname: Kobayashi
authors.forename: M
authors.initials: M
authors.lastname: Watanabe
authors.forename: K
authors.initials: K
authors.lastname: Nagafuji
authors.forename: S
authors.initials: S
authors.lastname: Yano
authors.forename: Y
authors.initials: Y
authors.lastname: Nawa
authors.forename: J
authors.initials: J
authors.lastname: Tomiyama
authors.forename: H
authors.initials: H
authors.lastname: Tashiro
authors.forename: Y
authors.initials: Y
authors.lastname: Nakamura
authors.forename: S
authors.initials: S
authors.lastname: Fujisawa
authors.forename: F
authors.initials: F
authors.lastname: Kimura
authors.forename: N
authors.initials: N
authors.lastname: Emi
authors.forename: I
authors.initials: I
authors.lastname: Miura
authors.forename: T
authors.initials: T
authors.lastname: Fukuda
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D014019:Tissue Donors / Q000706:statistics & numerical data / Q000600:supply & distribution*; D009927:Tissue and Organ Procurement / Q000706:statistics & numerical data; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult