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Mizuta S, Ugai T, Kato H, Doki N, Ota S, Kawakita T, Katayama Y, Kurokawa M, Nakamae H, Yano S, Nawa Y, Kanda Y, Fukuda T, Atsuta Y, Kako S. Propensity score matching/reweighting analysis comparing autologous and allogeneic stem cell transplantation for B-lineage acute lymphoblastic leukemia. Int J Hematol 2022; 116:393-400. [PMID: 35536509 DOI: 10.1007/s12185-022-03368-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/19/2022] [Accepted: 04/19/2022] [Indexed: 10/18/2022]
Abstract
We compared the outcomes of autologous stem cell transplantation (auto-SCT) with those of allogeneic stem cell transplantation (allo-SCT) from a human leukocyte antigen-matched related donor in patients with Philadelphia chromosome-negative B-lineage acute lymphoblastic leukemia (ALL). Newly diagnosed patients who underwent allo-SCT (n = 486) or auto-SCT (n = 99) after achieving first complete remission (CR) were included. Propensity score matching (PS) and an inverse probability of the treatment weighting (IPTW) analysis were applied to compensate for imbalances in baseline characteristics. The 5 years rates of overall survival (OS) among those in the PS-matched cohorts were 57% [95% confidence interval (CI) 46-67%] for those who received allo-SCT and 44% (95% CI 33-54%) for those who received auto-SCT. Multivariable, propensity score-matched, and IPTW analyses all revealed no statistically significant differences in OS between the two groups [hazard ratios (HR) 0.81, 95% CI 0.53-1.27, p = 0.36; HR 0.84, 95% CI 0.40-1.78, p = 0.65; HR 0.71, 95% CI 0.25-2.02, p = 0.53, respectively]. Prospective trials that include autologous transplantation as a treatment option are needed to examine the potential of autologous transplantation.
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Affiliation(s)
- Shuichi Mizuta
- Hematology and Immunology, Kanazawa Medical University, Uchinada, Japan.
| | - Tomotaka Ugai
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Harumi Kato
- Department of Hematology and Cell Therapy, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Noriko Doki
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Shuichi Ota
- Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan
| | - Toshiro Kawakita
- Department of Hematology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
| | - Yuta Katayama
- Department of Hematology, Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital, Hiroshima, Japan
| | - Mineo Kurokawa
- Department of Cell Therapy and Transplantation Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | | | - Shingo Yano
- Clinical Oncology and Hematology, The Jikei University School of Medicine, Tokyo, Japan
| | - Yuichiro Nawa
- Division of Hematology, Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - Yoshinobu Kanda
- Division of Hematology, Jichi Medical University, Shimotsuke, Japan
| | - Takahiro Fukuda
- Hematopoietic Stem Cell Transplantation Division, National Cancer Center Hospital, Tokyo, Japan
| | - Yoshiko Atsuta
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan
| | - Shinichi Kako
- Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan
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