Allogeneic hematopoietic stem cell transplantation for children and adolescents with high-risk cytogenetic AML: distinctly poor outcomes of FUS-ERG-positive cases View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2018-06-29

AUTHORS

Daisuke Tomizawa, Masanori Yoshida, Tadakazu Kondo, Takako Miyamura, Takashi Taga, Souichi Adachi, Katsuyoshi Koh, Maiko Noguchi, Harumi Kakuda, Kenichiro Watanabe, Yuko Cho, Takahiro Fukuda, Motohiro Kato, Norio Shiba, Hiroaki Goto, Keiko Okada, Masami Inoue, Yoshiko Hashii, Yoshiko Atsuta, Hiroyuki Ishida

ABSTRACT

Allocating patients with acute myeloid leukemia and high-risk cytogenetic abnormalities (HR-AML) for allogeneic hematopoietic stem cell transplantation (allo-HSCT) is part of the standard treatment protocol; however, whether allo-HSCT truly improves the outcomes in these patients is debatable. Data on 169 children and adolescents with HR-AML who received their first allo-HSCT in first or second remission between 2000 and 2015 were extracted from a nationwide, Japanese HSCT registry. The 3-year disease-free survival (DFS) and overall survival (OS) rates were 55.2% (95% CI, 46.8–62.9%) and 69.6% (61.4–76.3%), respectively, for all the HR-AML patients. In univariate analysis, the cytogenetic subgroup had a significant impact on both the DFS (P = 0.011) and OS (P < 0.001) rates. In particular, 14 patients with t(16;21) showed an extremely poor outcome. Additionally, older age at allo-HSCT (10–19 years old, P = 0.025), myeloablative conditioning with total-body irradiation (P = 0.019), and grade II–IV acute graft-versus-host disease (GVHD, P = 0.049) were associated with inferior OS. The donor type and occurrence of chronic GVHD did not affect the outcome. Multivariate analysis revealed t(16;21) to be associated with increased overall mortality (hazard ratio = 4.416, P < 0.001). Because the outcome of patients with certain HR-AML subgroups, such as t(16;21)-positive cases, is extremely poor even with allo-HSCT in remission, a novel therapy is urgently required. More... »

PAGES

393-401

Journal

TITLE

Bone Marrow Transplantation

ISSUE

3

VOLUME

54

Author Affiliations

  • Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
  • Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan
  • Department of Hematology and Oncology, Kyoto University, Kyoto, Japan
  • Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
  • Department of Pediatrics, Shiga University of Medical Science, Otsu, Japan
  • Department of Human Health Sciences, Kyoto University, Kyoto, Japan
  • Department of Hematology/Oncology, Saitama Children’s Medical Center, Saitama, Japan
  • Department of Pediatrics, National Kyushu Cancer Center, Fukuoka, Japan
  • Department of Hematology/Oncology, Chiba Children’s Hospital, Chiba, Japan
  • Department of Hematology and Oncology, Shizuoka Children’s Hospital, Shizuoka, Japan
  • Department of Pediatrics, Hokkaido University Hospital, Sapporo, Japan
  • Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
  • Department of Pediatrics, Yokohama City University Hospital, Yokohama, Japan
  • Division of Hemato/Oncology and Regenerative Medicine, Kanagawa Children’s Medical Center, Yokohama, Japan
  • Department of Pediatric Hematology/Oncology, Osaka City General Hospital, Osaka, Japan
  • Department of Hematology/Oncology, Osaka Women’s and Children’s Hospital, Osaka, Japan
  • Department of Healthcare Administration, Nagoya University, Nagoya, Japan
  • Department of Pediatrics, Kyoto City Hospital, Kyoto, Japan
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1038/s41409-018-0273-7

    DOI

    http://dx.doi.org/10.1038/s41409-018-0273-7

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1105215134

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/29959436


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