Allogeneic hematopoietic cell transplantation for adults with acute myeloid leukemia conducted in Japan during the past quarter century
Allogeneic hematopoietic cell transplantation for adults with acute myeloid leukemia conducted in Japan during the past quarter century
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过去四分之一个世纪在日本开展的针对成人急性髓系白血病的同种异体造血细胞移植
DOI：
10.1007/s00277-020-04051-0
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发表时间：
2020
影响因子：
3.5
通讯作者：
Yano Shingo
中科院分区：
文献类型：
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作者：
Yanada Masamitsu;Takami Akiyoshi;Yamasaki Satoshi;Arai Yasuyuki;Konuma Takaaki;Uchida Naoyuki;Najima Yuho;Fukuda Takahiro;Tanaka Masatsugu;Ozawa Yukiyasu;Ikegame Kazuhiro;Takanashi Minoko;Ichinohe Tatsuo;Okamoto Shinichiro;Atsuta Yoshiko;Yano Shingo
急性髓性白血病（AML）是异基因造血细胞移植（HCT）最常见的适应症。本研究旨在说明日本成人AML患者实施同种异体HCT的情况，并提供移植后结局的全面概述。为此，我们分析了1992年至2016年期间接受同种异体HCT的15，186例患者的数据，这些患者连续报告给日本全国移植登记处。每年移植数量的不断增加显然是由于无关移植的增长，脐带血移植目前占所有同种异体HCT的三分之一。自2000年以来，老年患者的比例稳步增加，大约与降低强度条件反射的引入平行。整个队列的总生存率（OS）概率估计为41%（95%置信区间（CI），40-42%），完全缓解（CR）移植患者为56%（95% CI，55-57%），非CR移植患者为22%（95% CI，21-23%）。多变量分析确定了年龄，性别，体能状态，疾病状态，细胞遗传学风险，供体类型，移植物来源，供体和受体之间的性别不匹配，以及移植年份与OS显著相关的因素。这些研究结果代表了日本的真实数据，显示了移植实践的变化和移植后结果的详细估计。
Acute myeloid leukemia (AML) represents the most common indication for allogeneic hematopoietic cell transplantation (HCT). This study aimed to address the implementation status of allogeneic HCT for adults with AML in Japan and to provide a comprehensive overview of post-transplant outcomes. For this purpose, we analyzed data of 15,186 patients undergoing allogeneic HCT between 1992 and 2016 who were consecutively reported to the Japanese nationwide transplantation registry. The constant increase in the annual number of transplantations was clearly attributable to the growth of unrelated transplantation, and umbilical cord blood transplantation currently accounts for one-third of all allogeneic HCTs. The proportion of older patients has increased steadily since 2000, approximately, in parallel with the introduction of reduced-intensity conditioning. The probability of overall survival (OS) was estimated at 41% (95% confidence interval (CI), 40–42%) for the entire cohort, 56% (95% CI, 55–57%) for patients transplanted in complete remission (CR), and 22% (95% CI, 21–23%) for those transplanted in non-CR. Multivariate analysis identified age, sex, performance status, disease status, cytogenetic risk, donor type, graft source, sex mismatch between the donor and the recipient, and year of transplantation as factors significantly associated with OS. These findings represent the real-world data in Japan, showing the changes in transplantation practice and a detailed estimation of post-transplant outcomes.