Allogeneic hematopoietic stem cell transplantation for the treatment of BCR-ABL1-negative atypical chronic myeloid leukemia and chronic neutrophil leukemia: A retrospective nationwide study in Japan.

Abstract

Atypical chronic myeloid leukemia (aCML) and chronic neutrophilic leukemia (CNL) are rare BCR-ABL1 fusion gene-negative myeloid neoplasms with a predominance of neutrophils. Since no standard therapeutic strategy currently exists for these diseases, we retrospectively evaluated the outcomes of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for aCML and CNL. Data from 14 aCML and 5 CNL patients as their diagnoses were collected using a nationwide survey. Allo-HSCT was performed between 2003 and 2014. Preconditioning regimens included myeloablative (n = 15), reduced-intensity (n = 3), and non-myeloablative (n = 1) regimens. Transplanted stem cells were obtained from HLA-matched related donors (n = 5) and alternative donors (n = 14). Neutrophil engraftment was successfully achieved in 17 patients. One-year overall survival rates (OS) were 54.4% (95% confidence interval [CI], 24.8 to 76.7%) and 40.0% (95% CI, 5.2 to 75.3%) in patients with aCML and CNL, respectively. Among aCML patients, 1-year OS were 76.2% (95% CI, 33.2 to 93.5%) and 20.0% (95% CI, 0.8 to 58.2%) in patients with <5% myeloblasts (n = 9) and ≥5% myeloblasts (n = 5) in peripheral blood before allo-HSCT, respectively. These results suggest that allo-HSCT achieves long-term survival in patients with aCML and CNL. Better pre-transplant management is required to improve the outcomes of aCML patients with ≥5% blasts in peripheral blood.

• Authors: Hidehiro Itonaga, Shuichi Ota, Takashi Ikeda, Hirohumi Taji, Itsuto Amano, Yuichi Hasegawa, Tatsuo Ichinohe, Takahiro Fukuda, Yoshiko Atsuta, Akihiko Tanizawa, Takeshi Kondo, Yasushi Miyazaki
• Journal: Leukemia research (Leuk Res) Vol. 75 Pg. 50-57 (12 2018) ISSN: 1873-5835 [Electronic] England
• PMID: 30458320 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2018 Elsevier Ltd. All rights reserved.

Topics

• Adolescent
• Adult
• Aged
• Child
• Disease-Free Survival
• Female
• Hematopoietic Stem Cell Transplantation (methods)
• Humans
• Japan
• Kaplan-Meier Estimate
• Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative (mortality, pathology, therapy)
• Leukemia, Neutrophilic, Chronic (mortality, pathology, therapy)
• Male
• Middle Aged
• Retrospective Studies
• Transplantation, Homologous
• Young Adult