Skip to main content
SpringerLink
Log in

Hematopoietic stem cell transplantation for acute promyelocytic leukemia in second or third complete remission: a retrospective analysis in the Nagoya Blood and Marrow Transplantation Group

  • Original Article
  • Published:
International Journal of Hematology Aims and scope Submit manuscript

Abstract

Acute promyelocytic leukemia (APL) is the most curable subtype of acute myeloid leukemia. Second complete remission (CR2) can be easily achieved with several therapeutic options even after relapse. However, the optimal strategy to treat APL in CR2 is still controversial. We retrospectively compared the outcome of autologous (auto) and allogeneic (allo) hematopoietic stem cell transplantation (HSCT) for patients with APL in CR2 or CR3. Fifteen patients received auto and 13 received allo HSCT between 1999 and 2004 at eight hospitals belonging to the Nagoya Blood and Marrow Transplantation Group. Four-year disease-free survival (DFS) and overall survival (OS) for autografted patients were 68.9 and 75.8%, whereas those for allografted patients were 46.2 (P = 0.350) and 46.2% (P = 0.185), respectively. Three autografted patients and one allografted patient relapsed, and one autografted patient and five allografted patients died without leukemia relapse. Among 14 autografted patients who were evaluated for MRD with molecular analysis, relapse occurred in one with positive MRD (n = 2) and two with negative MRD (n = 12). These data suggest that auto HSCT is very effective for APL in CR2 or CR3, and may be preferable to allo HSCT for a portion of patients. Prospective studies are required to define the role of auto HSCT in the treatment of relapsed APL.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Tallman MS, Nabhan C, Feusner JH, Rowe JM. Acute promyelocytic leukemia: evolving therapeutic strategies. Blood. 2002;99(3):759–67.

    Article  CAS  PubMed  Google Scholar 

  2. Tallman MS, Andersen JW, Schiffer CA, et al. All-trans retinoic acid in acute promyelocytic leukemia: long-term outcome and prognostic factor analysis from the North American Intergroup protocol. Blood. 2002;100(13):4298–302.

    Article  CAS  PubMed  Google Scholar 

  3. Asou N, Adachi K, Tamura J, et al. Analysis of prognostic factors in newly diagnosed acute promyelocytic leukemia treated with all-trans retinoic acid and chemotherapy. Japan Adult Leukemia Study Group. J Clin Oncol. 1998;16(1):78–85.

    Article  CAS  PubMed  Google Scholar 

  4. Thomas X, Dombret H, Cordonnier C, et al. Treatment of relapsing acute promyelocytic leukemia by all-trans retinoic acid therapy followed by timed sequential chemotherapy and stem cell transplantation. APL Study Group. Acute promyelocytic leukemia. Leukemia. 2000;14(6):1006–13.

    Article  CAS  PubMed  Google Scholar 

  5. Thomas X, Anglaret B, Thiebaut A, et al. Improvement of prognosis in refractory and relapsed acute promyelocytic leukemia over recent years: the role of all-trans retinoic acid therapy. Ann Hematol. 1997;75(5–6):195–200.

    Article  CAS  PubMed  Google Scholar 

  6. Shen ZX, Chen GQ, Ni JH, et al. Use of arsenic trioxide (As2O3) in the treatment of acute promyelocytic leukemia (APL): II. Clinical efficacy and pharmacokinetics in relapsed patients. Blood. 1997;89(9):3354–60.

    CAS  PubMed  Google Scholar 

  7. Douer D, Tallman MS. Arsenic trioxide: new clinical experience with an old medication in hematologic malignancies. J Clin Oncol. 2005;23(10):2396–410.

    Article  CAS  PubMed  Google Scholar 

  8. Tobita T, Takeshita A, Kitamura K, et al. Treatment with a new synthetic retinoid, Am80, of acute promyelocytic leukemia relapsed from complete remission induced by all-trans retinoic acid. Blood. 1997;90(3):967–73.

    CAS  PubMed  Google Scholar 

  9. Shinjo K, Takeshita A, Ohnishi K, et al. Good prognosis of patients with acute promyelocytic leukemia who achieved second complete remission (CR) with a new retinoid, Am80, after relapse from CR induced by all-trans-retinoic acid. Int J Hematol. 2000;72(4):470–3.

    CAS  PubMed  Google Scholar 

  10. Gorin NC. Autologous stem cell transplantation in acute myelocytic leukemia. Blood. 1998;92(4):1073–90.

    CAS  PubMed  Google Scholar 

  11. Meloni G, Diverio D, Vignetti M, et al. Autologous bone marrow transplantation for acute promyelocytic leukemia in second remission: prognostic relevance of pretransplant minimal residual disease assessment by reverse-transcription polymerase chain reaction of the PML/RAR alpha fusion gene. Blood. 1997;90(3):1321–5.

    CAS  PubMed  Google Scholar 

  12. de Botton S, Fawaz A, Chevret S, et al. Autologous and allogeneic stem-cell transplantation as salvage treatment of acute promyelocytic leukemia initially treated with all-trans-retinoic acid: a retrospective analysis of the European acute promyelocytic leukemia group. J Clin Oncol. 2005;23(1):120–6.

    Article  PubMed  Google Scholar 

  13. Ferrara F, Palmieri S, Annunziata M, et al. Prolonged molecular remission after autologous stem cell transplantation in relapsed acute promyelocytic leukemia. Haematologica. 2004;89(5):621–2.

    PubMed  Google Scholar 

  14. Grimwade D. The significance of minimal residual disease in patients with t(15;17). Best Pract Res Clin Haematol. 2002;15(1):137–58.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

We thank all the staff members of the transplantation teams participating in this study.

Author information

Authors and Affiliations

  1. Division of Hematology and Oncology, JA Aichi Showa Hospital, 46 Nobaku, Nobaku-cho, Konan, Aichi, 483-8703, Japan

    Akio Kohno & Yoshihisa Morishita

  2. Department of Hematology, Meitetsu Hospital, Nagoya, Japan

    Hiroatsu Iida & Hiroshi Sao

  3. Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Masamitsu Yanada & Tomoki Naoe

  4. Department of Hematology, Nagoya Daini Red Cross Hospital, Nagoya, Japan

    Toshiki Uchida

  5. Department of Hematology, Clinical and Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan

    Motohiro Hamaguchi

  6. Department of Hematology, Anjo Kosei Hospital, Anjo, Japan

    Masashi Sawa

  7. Department of Hematology, Toyohashi Municipal Hospital, Toyohashi, Japan

    Isamu Sugiura

  8. Department of Hematology and Cell Therapy, Aichi Cancer Center Hospital, Nagoya, Japan

    Kazuhito Yamamoto

  9. Department of Hematology, Fujita Health University Hospital, Toyoake, Japan

    Shuichi Mizuta

  10. Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan

    Koichi Miyamura

Authors
  1. Akio Kohno
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yoshihisa Morishita
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hiroatsu Iida
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Masamitsu Yanada
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Toshiki Uchida
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Motohiro Hamaguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Masashi Sawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Isamu Sugiura
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Kazuhito Yamamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Shuichi Mizuta
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Hiroshi Sao
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Tomoki Naoe
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Koichi Miyamura
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

For the Nagoya Blood and Marrow Transplantation Group

Corresponding author

Correspondence to Akio Kohno.

About this article

Cite this article

Kohno, A., Morishita, Y., Iida, H. et al. Hematopoietic stem cell transplantation for acute promyelocytic leukemia in second or third complete remission: a retrospective analysis in the Nagoya Blood and Marrow Transplantation Group. Int J Hematol 87, 210–216 (2008). https://doi.org/10.1007/s12185-008-0020-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12185-008-0020-8

Keywords

Search

Navigation