Clinical trials of combining the data from the Japan Society for Hematopoietic cell transplantation (JSHCT) and the Japan Adult Leukemia Study Group (JALSG)

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  • Kako Shinichi
    Division of Hematology, Saitama Medical Center, Jichi Medical University

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Other Title
  • 日本造血細胞移植学会（JSHCT）データと日本成人白血病治療共同研究グループ（JALSG）データを組み合わせた臨床研究の試み
  • —臨床決断分析による，成人急性リンパ性白血病第一寛解期における同種造血幹細胞移植施行の妥当性の検討—
  • —A decision analysis of allogeneic hematopoietic stem cell transplantation in adult patients with acute lymphoblastic leukemia in first remission—

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The execution of a prospective trial involving the random assignment of adult patients with acute lymphoblastic leukemia (ALL) in first remission who have a human leukocyte antigen (HLA) -matched related donor into 1 of the 2 groups, those undergoing hematopoietic stem cell transplantation (HSCT) or those treated with chemotherapy alone, is difficult in terms of practicality. Therefore, we performed a decision analysis to establish the optimal post-remission treatment in such patients. Transition probabilities after continuing chemotherapy in the first remission period, and after treatment with HSCT in patients with various disease statuses, were established according to the results of Japan Adult Leukemia Study Group (JALSG) prospective studies, and data from the Transplant Registry Unified Management Program (TRUMP) of Japan Society for Hematopoietic cell transplantation (JSHCT), respectively. As a result, the decision to perform HSCT in the first remission period, as opposed to continuing treatment with chemotherapy in this period, is recommended for adult patients with ALL who have an HLA-matched related donor. In addition, we were able to demonstrate efficacy when combining the large amount of clinical data regarding chemotherapy and HSCT. Further improvement in two large nationwide data obtained from results of JALSG studies regarding chemotherapy and from TRUMP of JSHCT regarding HSCT is anticipated, and the direct association between these 2 large data will generate important results with respect to treatment strategies for hematological diseases in Japan.

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