Altmetric

Allogeneic hematopoietic cell transplantation for primary refractory acute lymphoblastic leukemia: A report from the Acute Leukemia Working Party of the EBMT

File Description SizeFormat 
Accepted typescript.pdfAccepted version4.08 MBAdobe PDFView/Open
Title: Allogeneic hematopoietic cell transplantation for primary refractory acute lymphoblastic leukemia: A report from the Acute Leukemia Working Party of the EBMT
Authors: Pavlu, J
Labopin, M
Zoellner, AK
Sakellari, I
Stelljes, M
Finke, J
Fanin, R
Stuhler, G
Afanasyev, BV
Bloor, AJ
Anagnostopoulos, A
Mohty, M
Giebel, S
Nagler, A
Item Type: Journal Article
Abstract: BACKGROUND: Patients with primary refractory acute lymphoblastic leukemia (PREF ALL) who fail to achieve a complete remission (CR) after 2 courses of chemotherapy have a dismal prognosis without undergoing allogeneic hematopoietic cell transplantation (HCT). To the authors’ knowledge, there currently are no data regarding factors influencing transplantation outcomes. METHODS: The authors retrospectively studied outcomes of transplantation for cases of PREF ALL reported to European Society for Blood and Marrow Transplantation registry. Eligibility criteria for the current analysis included adult patients who underwent their first HCT for PREF ALL between 2000 and 2012. PREF disease was defined as the failure to achieve a morphological CR after 2 courses of induction chemotherapy. RESULTS: Data regarding 86 adult patients were analyzed. With a median follow-up of 106 months, the probability of survival was 36% at 2 years and 23% at 5 years. The probability of leukemia-free survival was 28% and 17%, respectively, and the probability of nonrecurrence mortality was 20% and 29%, respectively, at 2 years and 5 years. For 66 patients who achieved a CR (77%), the survival at 2 years and 5 years was 36% and 29%, respectively. In multivariate analysis, use of total body irradiation was found to be associated with improved survival. Total body irradiation and infusion of female hematopoietic cells into male recipients was associated with improved leukemia-free survival. These findings were incorporated into a scoring system that identified 3 groups (those with 2, 1, or no prognostic factors) with survival rates of 57%, 22%, and 8%, respectively. CONCLUSIONS: Although overall these patients would clearly benefit from the introduction of novel antileukemic therapies, the data from the current study support the use of allogeneic HCT in selected patients with PREF ALL.
Issue Date: 17-Feb-2017
Date of Acceptance: 28-Dec-2016
URI: http://hdl.handle.net/10044/1/49942
DOI: https://dx.doi.org/10.1002/cncr.30604
ISSN: 0008-543X
Publisher: Wiley
Start Page: 1965
End Page: 1970
Journal / Book Title: Cancer
Volume: 123
Issue: 11
Copyright Statement: © 2017 American Cancer Society. This is the accepted version of the following article: Pavlů, J., Labopin, M., Zoellner, A. K., Sakellari, I., Stelljes, M., Finke, J., Fanin, R., Stuhler, G., Afanasyev, B. V., Bloor, A. J., Anagnostopoulos, A., Mohty, M., Giebel, S. and Nagler, A. (2017), Allogeneic hematopoietic cell transplantation for primary refractory acute lymphoblastic leukemia: A report from the Acute Leukemia Working Party of the EBMT. Cancer, 123: 1965–1970. doi:10.1002/cncr.30604, which has been published in final form at https://dx.doi.org/10.1002/cncr.30604
Keywords: Science & Technology
Life Sciences & Biomedicine
Oncology
acute lymphoblastic leukemia (ALL)
allogeneic transplantation
conditioning regimen
refractory disease
stem cell transplantation
total body irradiation
ACUTE MYELOBLASTIC-LEUKEMIA
PRIMARY INDUCTION FAILURE
BONE-MARROW TRANSPLANTS
TOTAL-BODY IRRADIATION
CONDITIONING REGIMENS
T-CELL
IMPACT
RELAPSE
Adolescent
Adult
Aged
Antineoplastic Agents
Disease-Free Survival
Female
Follow-Up Studies
Hematopoietic Stem Cell Transplantation
Humans
Male
Middle Aged
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Prognosis
Remission Induction
Retrospective Studies
Survival Rate
Transplantation Conditioning
Transplantation, Homologous
Treatment Failure
Whole-Body Irradiation
Young Adult
1112 Oncology And Carcinogenesis
Oncology & Carcinogenesis
Publication Status: Published
Appears in Collections:Department of Medicine
Faculty of Medicine



Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Creative Commonsx