Acute myeloid leukemia (AML) represents the most common indication for allogeneic hematopoietic
cell transplantation (HCT). This study aimed to address the implementation status of allogeneic HCT for adults with AML in Japan and to provide a comprehensive overview of post-transplant outcomes. For this purpose, we analyzed data of 15,186 patients undergoing allogeneic HCT between 1992 and 2016 who were consecutively reported to the Japanese nationwide
transplantation registry. The constant increase in the annual number of
transplantations was clearly attributable to the growth of unrelated
transplantation, and umbilical cord blood
transplantation currently accounts for one-third of all allogeneic HCTs. The proportion of older patients has increased steadily since 2000, approximately, in parallel with the introduction of reduced-intensity conditioning. The probability of overall survival (OS) was estimated at 41% (95% confidence interval (CI), 40-42%) for the entire cohort, 56% (95% CI, 55-57%) for patients transplanted
in complete remission (CR), and 22% (95% CI, 21-23%) for those transplanted in non-CR. Multivariate analysis identified age, sex, performance status, disease status, cytogenetic risk, donor type, graft source, sex mismatch between the donor and the recipient, and year of
transplantation as factors significantly associated with OS. These findings represent the real-world data in Japan, showing the changes in
transplantation practice and a detailed estimation of post-transplant outcomes.