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日本成人急性髓系白血病造血细胞移植:对各项全国性登记研究结果的综述

Hematopoietic cell transplantation in adults with acute myeloid leukemia: A review of the results from various nationwide registry studies in Japan.

作者信息

Arai Yasuyuki, Konuma Takaaki, Yanada Masamitsu

机构信息

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

Division of Molecular Therapy, The Advanced Clinical Research Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.

出版信息

Blood Cell Ther. 2021 Apr 2;4(2):35-43. doi: 10.31547/bct-2020-023. eCollection 2021 May 25.

Abstract

Hematopoietic cell transplantation (HCT) is an integral part of the treatment of acute myeloid leukemia (AML). Although AML is the most common indication for allogeneic HCT, the relatively small number of patients and the highly complex nature of the procedure often render prospective studies on HCT unfeasible. Observational studies using registry data serve as important sources of information under such circumstances. Thus, the Japanese Society of Hematopoietic Cell Transplantation (JSHCT) has been conducting a nationwide survey of HCT since 1993, and this registration program now covers >99% of transplantation centers in Japan. A constant increase in the number of HCT procedures has been noted with recent annual registrations recording more than >1,000 new AML patients undergoing allogeneic or autologous HCT. Since its establishment in 2010, the Adult AML Working Group within the JSHCT has been using this registry data to complete several studies focusing on various aspects of HCT in adults with AML, with particular attention paid to patient-, disease-, and transplantation-related factors. This article comprehensively reviews the results obtained from these studies and discusses the strengths and limitations of these kinds of registry-based studies.

摘要

造血细胞移植(HCT)是急性髓系白血病(AML)治疗的一个重要组成部分。尽管AML是异基因HCT最常见的适应证,但患者数量相对较少以及该手术高度复杂的性质常常使得关于HCT的前瞻性研究不可行。在这种情况下,利用登记数据进行的观察性研究成为重要的信息来源。因此,日本造血细胞移植学会(JSHCT)自1993年以来一直在全国范围内开展HCT调查,目前该登记项目覆盖了日本99%以上的移植中心。近年来,HCT手术数量持续增加,最近的年度登记显示,每年有超过1000例新的AML患者接受异基因或自体HCT。自2010年成立以来,JSHCT内的成人AML工作组一直在利用这些登记数据完成多项研究,重点关注成人AML患者HCT的各个方面,尤其关注患者、疾病和移植相关因素。本文全面回顾了这些研究的结果,并讨论了这类基于登记的研究的优势和局限性。

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