Allogeneic Hematopoietic Cell Transplantation for Leukemic Transformation Preceded by Philadelphia Chromosome-Negative Myeloproliferative Neoplasms: A Nationwide Survey by the Adult Acute Myeloid Leukemia Working Group of the Japan Society for Hematopoietic Cell Transplantation.
To clarify the outcome of allogeneic hematopoietic cell transplantation (HCT) for leukemic transformation (LT) preceded by Philadelphia chromosome-negative (Ph-neg) myeloproliferative neoplasms (MPNs), we conducted a retrospective study using the national registry database of the Japan Society for Hematopoietic Cell Transplantation. From 2000 to 2013, 39 patients underwent their first allogeneic HCT with related bone marrow or peripheral blood stem cells (n = 8), unrelated bone marrow (n = 15), and unrelated umbilical cord blood (n = 16). The median patient age was 57 years. The underlying Ph-neg MPNs included 21 cases of essential thrombocythemia, 11 cases of primary myelofibrosis, and 7 cases of polycythemia vera. The median interval between the diagnosis of LT and transplantation was 134 days. Thirty-two cases (82%) were not in remission at the time of transplantation. The 2-year overall survival rate was 29.2% (95% confidence interval [CI], 15.5% to 44.3%). The median follow-up of the surviving patients was 1989.5 days (range, 285 to 3270). The cumulative incidences of relapse and nonrelapse mortality at 2 years were 34.4% (95% CI, 19.6% to 49.8%) and 34.2% (95% CI, 19.6% to 49.4%), respectively. The study results suggested that allogeneic HCT provides long-term survival in approximately one-third of patients with LT preceded by Ph-neg MPNs.
Department of Hematology, Toranomon Hospital, Tokyo, Japan; Adult AML Working Group, The Japan Society for Hematopoietic Cell Transplantation, Aichi, Japan. Electronic address: shinsuke-takagi@umin.net.
Shinsuke
S
Takagi
Adult AML Working Group, The Japan Society for Hematopoietic Cell Transplantation, Aichi, Japan; Department of Hematology, Mishuku Hospital, Tokyo, Japan.
Kazuhiro
K
Masuoka
Department of Hematology, Toranomon Hospital, Tokyo, Japan.
Naoyuki
N
Uchida
Department of Cell Therapy and Transplantation Medicine, The University of Tokyo Hospital, Tokyo, Japan.
Mineo
M
Kurokawa
Department of Hematology, Osaka City University Hospital, Osaka, Japan.
Hirohisa
H
Nakamae
Department of Hematology, Osaka Red Cross Hospital, Osaka, Japan.
Kazunori
K
Imada
Department of Hematology, Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital, Hiroshima, Japan.
Koji
K
Iwato
Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan.
Tatsuo
T
Ichinohe
Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Aichi, Japan; Japanese Data Center for Hematopoietic Cell Transplantation, Aichi, Japan.
Yoshiko
Y
Atsuta
Adult AML Working Group, The Japan Society for Hematopoietic Cell Transplantation, Aichi, Japan; Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Aichi, Japan.
Akiyoshi
A
Takami
Adult AML Working Group, The Japan Society for Hematopoietic Cell Transplantation, Aichi, Japan; Division of Clinical Oncology and Hematology, Jikei University School of Medicine, Tokyo, Japan.
Shingo
S
Yano
D000328:Adult; D000368:Aged; D002471:Cell Transformation, Neoplastic; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D007564:Japan; D007938:Leukemia / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D008875:Middle Aged; D009196:Myeloproliferative Disorders / Q000150:complications / Q000628:therapy*; D010677:Philadelphia Chromosome; D011087:Polycythemia Vera; D055728:Primary Myelofibrosis; D012189:Retrospective Studies; D013922:Thrombocytosis; D061665:Time-to-Treatment; D014184:Transplantation, Homologous; D055815:Young Adult
Acute myeloid leukemia; Allogeneic hematopoietic cell transplantation; Myeloproliferative neoplasm