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- Title
Status of minimal residual disease determines outcome of autologous hematopoietic SCT in adult ALL.
- Authors
Giebel, S.; Stella-Holowiecka, B.; Krawczyk-Kulis, M.; Gökbuget, N.; Hoelzer, D.; Doubek, M.; Mayer, J.; Piatkowska-Jakubas, B.; Skotnicki, A. B.; Dombret, H.; Ribera, J. M.; Piccaluga, P. P.; Czerw, T.; Kyrcz-Krzemien, S.; Holowiecki, J.
- Abstract
The role of autologous hematopoietic SCT (autoHSCT) in the treatment of high-risk (HR) adult ALL is controversial. In this study, we retrospectively analyzed the results of autoHSCT according to the status of minimal residual disease (MRD) at transplantation, as a joint analysis of the European Study Group for Adult ALL (EWALL). Data on 123 recipients of autoHSCT, aged 31 (16–59) years, with B-lineage (n=77) or T-lineage (n=46) ALL were included. In a cohort of Ph-negative ALL, the probability of leukemia-free survival at 5 years was higher for patients with MRD <0.1% compared with those with MRD 0.1% (57 vs 17%, P=0.0002). The difference was significant for T-lineage ALL (62 vs 8%, P=0.001), and a tendency was observed for B-lineage ALL (54 vs 26%, P=0.17). In a multivariate analysis, adjusted for other potential prognostic factors, high MRD level remained the only independent factor associated with increased risk of failure (risk ratio, 2.8; P=0.0005). We conclude that MRD determines the outcome of autoHSCT in HR adult ALL. Our results suggest the need to reevaluate the role of this treatment option in prospective trials.
- Subjects
AUTOTRANSFUSION of blood; HEMATOPOIETIC stem cells; HEMATOPOIETIC growth factors; DISEASE complications; LEUKEMIA; LEUKEMIA treatment; DECISION making; PROGNOSIS; PATIENTS; THERAPEUTICS
- Publication
Bone Marrow Transplantation, 2010, Vol 45, Issue 6, p1095
- ISSN
0268-3369
- Publication type
Article
- DOI
10.1038/bmt.2009.308