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- Title
Donor-specific differences in long-term outcomes of myeloablative transplantation in adults with Philadelphia-negative acute lymphoblastic leukemia.
- Authors
Lee, S.; Chung, N.-G.; Cho, B.-S.; Eom, K.-S.; Kim, Y.-J.; Kim, H.-J.; Min, C.-K.; Cho, S.-G.; Kim, D.-W.; Lee, J.-W.; Min, W.-S.; Park, C.-W.; Kim, C.-C.
- Abstract
We analyzed long-term outcomes of myeloablative stem cell transplantation (SCT) in 292 adults with Philadelphia (Ph)-negative acute lymphoblastic leukemia (ALL). Donors were related (RD; n=132), unrelated (URD; n=68; 30 well-matched (WM), 19 partially matched (PM), 19 mismatched (MM)) and autologous (AUTO; n=92). After a median follow-up of 85 months, the risk of relapse was higher for AUTO-SCT than for RD-SCT (P<0.001). MM-URD-SCT yielded higher risk of non-relapse mortality than RD-SCT (P=0.010). As a result, disease-free survival (DFS) at 5 years was inferior using AUTO (46.1%; P=0.010) or MM-URD (26.3%; P=0.036), whereas DFS from other donor sources was approximately equivalent (53.5% for RD, 63.3% for WM-URD and 57.0% for PM-URD). Other factors associated with poorer DFS included SCT beyond first complete remission (CR), older age and adverse cytogenetics. In a pairwise comparison of outcomes between RD-SCT and AUTO-SCT for patients in first CR, the inferiority of AUTO-SCT was observed, particularly in high-risk patients. Conversely, in standard-risk patients, AUTO-SCT yielded comparable outcomes to RD-SCT. SCT using RD, WM-URD or PM-URD may be considered the best donor sources for adult high-risk Ph-negative ALL.
- Subjects
LYMPHOBLASTIC leukemia; STEM cell transplantation; CYTOGENETICS; MORTALITY; GERMFREE life
- Publication
Leukemia (08876924), 2010, Vol 24, Issue 12, p2110
- ISSN
0887-6924
- Publication type
Article
- DOI
10.1038/leu.2010.217