Long-term outcomes of adults with acute lymphoblastic leukemia after autologous or unrelated donor bone marrow transplantation: A comparative analysis by the National Marrow Donor Program and Center for International Blood and Marrow Transplant Research

M. R. Bishop, B. R. Logan, S. Gandham, B. J. Bolwell, J. Y. Cahn, H. M. Lazarus, Mark R Litzow, D. I. Marks, P. H. Wiernik, P. L. McCarthy, J. A. Russell, C. B. Miller, J. Sierra, G. Milone, A. Keating, F. R. Loberiza, S. Giralt, M. M. Horowitz, D. J. Weisdorf

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

For adults with high-risk or recurrent ALL who lack a suitable sibling donor, the decision between autologous (Auto) and unrelated donor (URD) hematopoietic stem cell transplantation (HSCT) is difficult due to variable risks of relapse and treatment-related mortality (TRM). We analysed data from two transplant registries to determine outcomes between Auto and URD HSCT for 260 adult ALL patients in first (CR1) or second (CR2) CR. All patients received a myeloablative conditioning regimen. The median follow-up was 77 (range 12-170) months. TRM at 1 year post transplant was significantly higher with URD HSCT; however, there were minimal differences in TRM according to disease status. Relapse was higher with Auto HSCT and was increased in patients transplanted in CR2. Five-year leukemia-free (37 vs 39%) and overall survival (OS) rates (38 vs 39%) were similar for Auto HSCT vs URD HSCT in CR1. There were trends favoring URD HSCT in CR2. The long-term follow-up in this analysis demonstrated that either Auto or URD HSCT could result in long-term leukaemia-free survival and OS for adult ALL patients. The optimal time (CR1 vs CR2) and technique to perform HSCT remains an important clinical question for adult ALL patients.

Original languageEnglish (US)
Pages (from-to)635-642
Number of pages8
JournalBone Marrow Transplantation
Volume41
Issue number7
DOIs
StatePublished - Apr 2008

Fingerprint

Unrelated Donors
Hematopoietic Stem Cell Transplantation
Bone Marrow Transplantation
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Bone Marrow
Tissue Donors
Transplants
Research
Mortality
Leukemia
Recurrence
Survival
Registries
Siblings
Therapeutics
Survival Rate

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Long-term outcomes of adults with acute lymphoblastic leukemia after autologous or unrelated donor bone marrow transplantation : A comparative analysis by the National Marrow Donor Program and Center for International Blood and Marrow Transplant Research. / Bishop, M. R.; Logan, B. R.; Gandham, S.; Bolwell, B. J.; Cahn, J. Y.; Lazarus, H. M.; Litzow, Mark R; Marks, D. I.; Wiernik, P. H.; McCarthy, P. L.; Russell, J. A.; Miller, C. B.; Sierra, J.; Milone, G.; Keating, A.; Loberiza, F. R.; Giralt, S.; Horowitz, M. M.; Weisdorf, D. J.

In: Bone Marrow Transplantation, Vol. 41, No. 7, 04.2008, p. 635-642.

Research output: Contribution to journalArticle

Bishop, MR, Logan, BR, Gandham, S, Bolwell, BJ, Cahn, JY, Lazarus, HM, Litzow, MR, Marks, DI, Wiernik, PH, McCarthy, PL, Russell, JA, Miller, CB, Sierra, J, Milone, G, Keating, A, Loberiza, FR, Giralt, S, Horowitz, MM & Weisdorf, DJ 2008, 'Long-term outcomes of adults with acute lymphoblastic leukemia after autologous or unrelated donor bone marrow transplantation: A comparative analysis by the National Marrow Donor Program and Center for International Blood and Marrow Transplant Research', Bone Marrow Transplantation, vol. 41, no. 7, pp. 635-642. https://doi.org/10.1038/sj.bmt.1705952
Bishop, M. R. ; Logan, B. R. ; Gandham, S. ; Bolwell, B. J. ; Cahn, J. Y. ; Lazarus, H. M. ; Litzow, Mark R ; Marks, D. I. ; Wiernik, P. H. ; McCarthy, P. L. ; Russell, J. A. ; Miller, C. B. ; Sierra, J. ; Milone, G. ; Keating, A. ; Loberiza, F. R. ; Giralt, S. ; Horowitz, M. M. ; Weisdorf, D. J. / Long-term outcomes of adults with acute lymphoblastic leukemia after autologous or unrelated donor bone marrow transplantation : A comparative analysis by the National Marrow Donor Program and Center for International Blood and Marrow Transplant Research. In: Bone Marrow Transplantation. 2008 ; Vol. 41, No. 7. pp. 635-642.
@article{92b3c6d5a3d34f34981f0ff33301eee0,
title = "Long-term outcomes of adults with acute lymphoblastic leukemia after autologous or unrelated donor bone marrow transplantation: A comparative analysis by the National Marrow Donor Program and Center for International Blood and Marrow Transplant Research",
abstract = "For adults with high-risk or recurrent ALL who lack a suitable sibling donor, the decision between autologous (Auto) and unrelated donor (URD) hematopoietic stem cell transplantation (HSCT) is difficult due to variable risks of relapse and treatment-related mortality (TRM). We analysed data from two transplant registries to determine outcomes between Auto and URD HSCT for 260 adult ALL patients in first (CR1) or second (CR2) CR. All patients received a myeloablative conditioning regimen. The median follow-up was 77 (range 12-170) months. TRM at 1 year post transplant was significantly higher with URD HSCT; however, there were minimal differences in TRM according to disease status. Relapse was higher with Auto HSCT and was increased in patients transplanted in CR2. Five-year leukemia-free (37 vs 39{\%}) and overall survival (OS) rates (38 vs 39{\%}) were similar for Auto HSCT vs URD HSCT in CR1. There were trends favoring URD HSCT in CR2. The long-term follow-up in this analysis demonstrated that either Auto or URD HSCT could result in long-term leukaemia-free survival and OS for adult ALL patients. The optimal time (CR1 vs CR2) and technique to perform HSCT remains an important clinical question for adult ALL patients.",
author = "Bishop, {M. R.} and Logan, {B. R.} and S. Gandham and Bolwell, {B. J.} and Cahn, {J. Y.} and Lazarus, {H. M.} and Litzow, {Mark R} and Marks, {D. I.} and Wiernik, {P. H.} and McCarthy, {P. L.} and Russell, {J. A.} and Miller, {C. B.} and J. Sierra and G. Milone and A. Keating and Loberiza, {F. R.} and S. Giralt and Horowitz, {M. M.} and Weisdorf, {D. J.}",
year = "2008",
month = "4",
doi = "10.1038/sj.bmt.1705952",
language = "English (US)",
volume = "41",
pages = "635--642",
journal = "Bone Marrow Transplantation",
issn = "0268-3369",
publisher = "Nature Publishing Group",
number = "7",

}

TY - JOUR

T1 - Long-term outcomes of adults with acute lymphoblastic leukemia after autologous or unrelated donor bone marrow transplantation

T2 - A comparative analysis by the National Marrow Donor Program and Center for International Blood and Marrow Transplant Research

AU - Bishop, M. R.

AU - Logan, B. R.

AU - Gandham, S.

AU - Bolwell, B. J.

AU - Cahn, J. Y.

AU - Lazarus, H. M.

AU - Litzow, Mark R

AU - Marks, D. I.

AU - Wiernik, P. H.

AU - McCarthy, P. L.

AU - Russell, J. A.

AU - Miller, C. B.

AU - Sierra, J.

AU - Milone, G.

AU - Keating, A.

AU - Loberiza, F. R.

AU - Giralt, S.

AU - Horowitz, M. M.

AU - Weisdorf, D. J.

PY - 2008/4

Y1 - 2008/4

N2 - For adults with high-risk or recurrent ALL who lack a suitable sibling donor, the decision between autologous (Auto) and unrelated donor (URD) hematopoietic stem cell transplantation (HSCT) is difficult due to variable risks of relapse and treatment-related mortality (TRM). We analysed data from two transplant registries to determine outcomes between Auto and URD HSCT for 260 adult ALL patients in first (CR1) or second (CR2) CR. All patients received a myeloablative conditioning regimen. The median follow-up was 77 (range 12-170) months. TRM at 1 year post transplant was significantly higher with URD HSCT; however, there were minimal differences in TRM according to disease status. Relapse was higher with Auto HSCT and was increased in patients transplanted in CR2. Five-year leukemia-free (37 vs 39%) and overall survival (OS) rates (38 vs 39%) were similar for Auto HSCT vs URD HSCT in CR1. There were trends favoring URD HSCT in CR2. The long-term follow-up in this analysis demonstrated that either Auto or URD HSCT could result in long-term leukaemia-free survival and OS for adult ALL patients. The optimal time (CR1 vs CR2) and technique to perform HSCT remains an important clinical question for adult ALL patients.

AB - For adults with high-risk or recurrent ALL who lack a suitable sibling donor, the decision between autologous (Auto) and unrelated donor (URD) hematopoietic stem cell transplantation (HSCT) is difficult due to variable risks of relapse and treatment-related mortality (TRM). We analysed data from two transplant registries to determine outcomes between Auto and URD HSCT for 260 adult ALL patients in first (CR1) or second (CR2) CR. All patients received a myeloablative conditioning regimen. The median follow-up was 77 (range 12-170) months. TRM at 1 year post transplant was significantly higher with URD HSCT; however, there were minimal differences in TRM according to disease status. Relapse was higher with Auto HSCT and was increased in patients transplanted in CR2. Five-year leukemia-free (37 vs 39%) and overall survival (OS) rates (38 vs 39%) were similar for Auto HSCT vs URD HSCT in CR1. There were trends favoring URD HSCT in CR2. The long-term follow-up in this analysis demonstrated that either Auto or URD HSCT could result in long-term leukaemia-free survival and OS for adult ALL patients. The optimal time (CR1 vs CR2) and technique to perform HSCT remains an important clinical question for adult ALL patients.

UR - http://www.scopus.com/inward/record.url?scp=42149177725&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=42149177725&partnerID=8YFLogxK

U2 - 10.1038/sj.bmt.1705952

DO - 10.1038/sj.bmt.1705952

M3 - Article

C2 - 18084335

AN - SCOPUS:42149177725

VL - 41

SP - 635

EP - 642

JO - Bone Marrow Transplantation

JF - Bone Marrow Transplantation

SN - 0268-3369

IS - 7

ER -