Role of autotransplantation in the treatment of acute promyelocytic leukemia patients in remission: Fukuoka BMT Group observations and a literature review

Kamimura, Tomohiko; Miyamoto, Toshihiro; Nagafuji, Koji; Numata, Akihiko; Henzan, Hideho; Takase, Ken; Ito, Yoshikiyo; Ohno, Yuju; Fujisaki, Tomoaki; Eto, Tetsuya; Takamatsu, Yasushi; Teshima, Takanori; Gondo, Hisashi; Akashi, Koichi; Taniguchi, Shuichi; Harada, Mine

doi:10.1038/bmt.2010.207

Cited by 12 publications

(9 citation statements)

References 27 publications

(42 reference statements)

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“…29 Results of 1 prospective study in 15 patients with APL suggest using PCR status to help determine auto- vs. allo-HCT, which concluded that, for patients with APL in CR2 and PCR negativity, auto-HCT be considered and that, for patients with PCR positivity, more aggressive regimens be considered, including those regimens based on allo-HCT. 27 In our study, 7 (100%) of 7 patients who underwent auto-HCT only as HCT-based therapy were in CR at the time of HCT, and, of these patients, 5 (71%) of 7 were found to be in MR. All but one of these patients was in CR2 or beyond. The 7-year relapse-free survival for the auto-HCT group was 68.6% and the 7-year OS was 85.7%, with a TRM of 10%, which suggests that auto-HCT is indeed an effective treatment in CR2 and beyond for patients with relapsed APL.…”

Section: Discussionmentioning

confidence: 47%

“…18 A retrospective study of 26 patients with APL who achieved either CR1 or CR2 and who underwent auto-HCT demonstrated that this might be an effective treatment option, especially in high-risk patients with APL. 27 In another study, of 37 patients with relapsed APL, 14 patients received auto-HCT. Compared with the 19 patients who received CT alone, the investigators concluded that treatment that involved an auto-HCT resulted in significantly superior results after a remission induction with ATO-based regimens at relapse.…”

Section: Discussionmentioning

confidence: 99%

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Outcomes in Patients With Relapsed or Refractory Acute Promyelocytic Leukemia Treated With or Without Autologous or Allogeneic Hematopoietic Stem Cell Transplantation

Pemmaraju

Tanaka

Ravandi

et al. 2013

Clinical Lymphoma Myeloma and Leukemia

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Outcomes in patients with acute promyelocytic leukemia have improved; however, a subset of patients relapse despite receiving all-trans-retinoic acid and/or arsenic-based therapies. Among 40 patients with acute promyelocytic leukemia who were treated at our institution (1980–2010), 24 received hematopoietic stem cell transplantation (HCT) (autologous HCT, 7; allogeneic HCT, 14; both, 3); 16 received chemotherapy only. All 3 strategies (autologous HCT, allogeneic HCT, chemotherapy) were feasible in patients with relapsed acute promyelocytic leukemia and result in long-term disease control in selected patients. Background Outcomes in patients with acute promyelocytic leukemia (APL) have improved; however, a significant number of patients still relapse despite receiving all-trans-retinoic acid (ATRA) and arsenic-based therapies. Patients and Methods Outcomes of patients with relapsed APL who were treated at our institution (1980–2010) and who received HCT were compared with those who received chemotherapy (CT) only. Results Among 40 patients, 24 received HCT (autologous [auto] HCT, 7; allogeneic [allo] HCT, 14; both, 3); 16 received CT only. The median age at diagnosis was 36 years (range, 13–50 years), 31 years (range, 16–58 years), and 44 years (range, 24–79 years) for the auto-HCT, allo-HCT, and CT groups, respectively. Ten (100%) patients who received auto-HCT and 12 (71%) who received allo-HCT were in complete remission at the time of the HCT. The median follow-ups in the auto-HCT, allo-HCT, and CT groups were 74 months (range, 26–135 months), 118 months (range, 28–284 months), and 122 months (range, 32–216 months), respectively. Transplantation-related mortality (1 year) after auto-HCT and allo-HCT were 10% and 29%, respectively. The 7-year event-free survival after auto-HCT and allo-HCT was 68.6% and 40.6%, respectively (P = .45). The 7-year overall survival was 85.7%, 49.4%, and 40% in the auto-HCT, allo-HCT, and CT groups, respectively (P = .48). Conclusion Both auto-HCT and allo-HCT are associated with durable remission and prolonged survival. All 3 strategies (auto-HCT, allo-HCT, CT) were found to be feasible in the relapsed APL setting and result in long-term disease control in selected patients. In this retrospective analysis, overall survival for patients who received HCT was not significantly better than patients who received CT only, but a trend toward better outcomes was seen in patients who underwent auto-HCT, although not statistically significant.

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Section: Discussionmentioning

confidence: 47%

Section: Discussionmentioning

confidence: 99%

Outcomes in Patients With Relapsed or Refractory Acute Promyelocytic Leukemia Treated With or Without Autologous or Allogeneic Hematopoietic Stem Cell Transplantation

Pemmaraju

Tanaka

Ravandi

et al. 2013

Clinical Lymphoma Myeloma and Leukemia

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“…Recently, the Auto-PBSCT on tumor has got an extensive application in tumor treatment. It's safer and more effective than allograft because of less rejection, material easier to get and rapid bone marrow hematopoietic recovery (Palmieri et al, 2007;Uehara et al, 2008;Niwa et al, 2009;Kamimura et al, 2011). In this study, 3 patients received Auto-PBSCT treatment and 2 achieved complete remission.…”

Section: Discussionmentioning

confidence: 99%

Clinical Character of Pediatric Head and Neck Rhabdomysarcomas: A 7-Year Retrospective Study

Zhang¹,

Zhang²,

Huang³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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“…75 For the 15% patients who relapse, ASCT with PML-RAR-negative cells is a therapeutic option in CR2. [76][77][78] In the largest case series reported recently, CIBMTR 79 reviewed 294 patients with M3 AML treated with allo-HSCT (n = 232) or ASCT (n = 62). Multivariate analysis showed that, compared with allo-HSCT, ASCT was associated with higher LFS (63% vs 50%, P = 0.01) and OS (75% vs 54%, P = 0.0006) at 5 years.…”

mentioning

confidence: 99%

Autologous stem cell transplantation for adult acute leukemia in 2015: time to rethink? Present status and future prospects

Gorin

Giebel

Labopin

et al. 2015

Bone Marrow Transplant

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The use of autologous stem cell transplantation (ASCT) as consolidation therapy for adult patients with acute leukemia has declined over time. However, multiple randomized studies in the past have reported lower relapse rates after autologous transplantation compared with chemotherapy and lower non-relapse mortality rates compared with allogeneic transplantation. In addition, quality of life of long-term survivors is better after autologous transplantation than after allogeneic transplantation. Further, recent developments may improve outcomes of autograft recipients. These include the use of IV busulfan and the busulfan+melphalan combination, better detection of minimal residual disease (MRD) with molecular biology techniques, the introduction of targeted therapies and post-transplant maintenance therapy. Therefore, ASCT may nowadays be reconsidered for consolidation in the following patients if and when they reach a MRD-negative status: good-and at least intermediate-1 risk acute myelocytic leukemia in first CR, acute promyelocytic leukemia in second CR, Ph-positive acute lymphocytic leukemia. Conversely, patients with MRDpositive status or high-risk leukemia should not be considered for consolidation with ASCT.

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Role of autotransplantation in the treatment of acute promyelocytic leukemia patients in remission: Fukuoka BMT Group observations and a literature review

Cited by 12 publications

References 27 publications

Outcomes in Patients With Relapsed or Refractory Acute Promyelocytic Leukemia Treated With or Without Autologous or Allogeneic Hematopoietic Stem Cell Transplantation

Outcomes in Patients With Relapsed or Refractory Acute Promyelocytic Leukemia Treated With or Without Autologous or Allogeneic Hematopoietic Stem Cell Transplantation

Clinical Character of Pediatric Head and Neck Rhabdomysarcomas: A 7-Year Retrospective Study

Autologous stem cell transplantation for adult acute leukemia in 2015: time to rethink? Present status and future prospects

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