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- Title
Haploidentical hematopoietic SCT may be superior to conventional consolidation/maintenance chemotherapy as post-remission therapy for high-risk adult ALL.
- Authors
Sun, Y-q; Wang, J; Jiang, Q; Xu, L-p; Liu, D-h; Zhang, X-h; Liu, K-y; Huang, X-j
- Abstract
Only 30% of high-risk adult ALL patients in their first complete remission (CR1) are able to receive an HLA-matched sibling stem cell transplant. The role of haploidentical hematopoietic SCT (haplo-HSCT) in post-remission therapy is not well established. Recently, we developed a novel protocol for unmanipulated haploidentical transplantation. In this study, we compared haplo-HSCT with conventional consolidation and maintenance chemotherapy in adult high-risk ALL patients. Between January 2000 and December 2012, 104 patients received conventional chemotherapy and 79 patients received haplo-HSCT. Patients who underwent haplo-HSCT had significantly improved 3-year OS (72.5% vs 26.6%; P<0.001), 3-year disease-free survival (DFS) (63.9% vs 21.1%; P<0.001) and 3-year relapse (18.7% vs 60.5%; P<0.001) rates. The non-relapse mortality (NRM) rate was not different between patients treated with haplo-HSCT vs chemotherapy (19.2% vs 14.4%; P=0.80). In multivariate analysis, the only factor associated with improved OS, better DFS and low risk of relapse was haplo-HSCT. The only factor associated with high NRM was enrollment before 2006. In conclusion, haplo-HSCT may be an option for adults with high-risk ALL in CR1 who do not have an HLA-matched donor.
- Subjects
CANCER chemotherapy; CELL transplantation; CELLULAR therapy; HAPLOIDY; STEM cell transplantation
- Publication
Bone Marrow Transplantation, 2015, Vol 50, Issue 1, p20
- ISSN
0268-3369
- Publication type
Article
- DOI
10.1038/bmt.2014.195