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 language | English (US) |
|---|---|
| Pages (from-to) | 635-642 |
| Number of pages | 8 |
| Journal | Bone Marrow Transplantation |
| Volume | 41 |
| Issue number | 7 |
| DOIs | |
| State | Published - Apr 2008 |
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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 journal › Article
}
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 -