TY - JOUR
T1 - Allogeneic Stem Cell Transplantation for Acute Lymphoblastic Leukemia in Adolescents and Young Adults
AU - Hangai, Mayumi
AU - Urayama, Kevin Y.
AU - Tanaka, Junji
AU - Kato, Koji
AU - Nishiwaki, Satoshi
AU - Koh, Katsuyoshi
AU - Noguchi, Maiko
AU - Kato, Keisuke
AU - Yoshida, Nao
AU - Sato, Maho
AU - Goto, Hiroaki
AU - Yuza, Yuki
AU - Hashii, Yoshiko
AU - Atsuta, Yoshiko
AU - Mizuta, Shuichi
AU - Kato, Motohiro
N1 - Funding Information:
Financial disclosure: This work was supported in part by a Research Grant for Allergic Disease and Immunology from the Japanese Ministry of Health, Labor, and Welfare (to Y.A.), and research grants from the National Center for Child Health and Development ( 28-5 and 29-8; to M.K. ).
Funding Information:
The authors thank all the staff at participating hospitals and centers who provided valuable clinical data for the JSHCT registry, as well as Aurelie Piedvache for advising on statistical methods. Financial disclosure: This work was supported in part by a Research Grant for Allergic Disease and Immunology from the Japanese Ministry of Health, Labor, and Welfare (to Y.A.), and research grants from the National Center for Child Health and Development (28-5 and 29-8; to M.K.). Conflict of interest statement: There are no conflicts of interest to report.
Publisher Copyright:
© 2019 American Society for Blood and Marrow Transplantation
PY - 2019/8
Y1 - 2019/8
N2 - Hematologic stem cell transplantation (HSCT) is the most potent consolidation therapy for high-risk acute lymphoblastic leukemia (ALL), but their outcomes and complications in adolescent and young adult (AYA) patients remain unclear. We compared outcomes after HSCT for ALL among children (age 1 to 9 years; n = 607), adolescents (age 10 to 19 years; n = 783), and young adults (age 20 to 29 years old, n = 603), based on Japanese nationwide registry data. The 5-year overall survival (OS) rate among AYA patients was worse than that of children, at 64% (95% confidence interval [CI], 60% to 68%). In the AYA, the 5-year treatment-related mortality (TRM) after HSCT was 19% (95% CI, 16% to 22%), significantly higher than that in younger patients. The most common cause of TRM in the AYA was infection. The relapse rate was not different across the 3 age groups. When focusing on older adolescents (age 15 to 19 years), there was no difference in outcomes between those treated in pediatric centers and those treated in adult centers. In conclusion, the AYA had a greater risk of nonrelapse death than younger patients, and infection was the most common cause. Further optimization is required for HSCT in AYAs with ALL.
AB - Hematologic stem cell transplantation (HSCT) is the most potent consolidation therapy for high-risk acute lymphoblastic leukemia (ALL), but their outcomes and complications in adolescent and young adult (AYA) patients remain unclear. We compared outcomes after HSCT for ALL among children (age 1 to 9 years; n = 607), adolescents (age 10 to 19 years; n = 783), and young adults (age 20 to 29 years old, n = 603), based on Japanese nationwide registry data. The 5-year overall survival (OS) rate among AYA patients was worse than that of children, at 64% (95% confidence interval [CI], 60% to 68%). In the AYA, the 5-year treatment-related mortality (TRM) after HSCT was 19% (95% CI, 16% to 22%), significantly higher than that in younger patients. The most common cause of TRM in the AYA was infection. The relapse rate was not different across the 3 age groups. When focusing on older adolescents (age 15 to 19 years), there was no difference in outcomes between those treated in pediatric centers and those treated in adult centers. In conclusion, the AYA had a greater risk of nonrelapse death than younger patients, and infection was the most common cause. Further optimization is required for HSCT in AYAs with ALL.
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U2 - 10.1016/j.bbmt.2019.04.014
DO - 10.1016/j.bbmt.2019.04.014
M3 - Article
C2 - 31002992
AN - SCOPUS:85065519009
SN - 1083-8791
VL - 25
SP - 1597
EP - 1602
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 8
ER -