We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Outcome after first relapse in adult patients with Philadelphia chromosome-negative acute lymphoblastic leukaemia.
- Authors
Kako, Shinichi; Kanamori, Heiwa; Kobayashi, Naoki; Shigematsu, Akio; Nannya, Yasuhito; Nakamae, Mika; Shigeno, Kazuyuki; Suzukawa, Kazumi; Takeuchi, Masahiro; Tsuzuki, Motohiro; Usuki, Kensuke; Hatanaka, Kazuo; Ogawa, Kazuei; Mitani, Kinuko; Nawa, Yuichiro; Hatta, Yoshihiro; Mizuno, Ishikazu; Kanda, Yoshinobu
- Abstract
To analyse the outcome of adult patients who developed a first relapse of acute lymphoblastic leukaemia ( ALL), we collected the clinical data of 332 patients with Philadelphia-chromosome (Ph) negative ALL, aged 16-65 years, who relapsed after first complete remission ( CR1) between 1998 and 2008 in 69 institutions all over Japan, including 58 patients who relapsed after allogeneic haematopoietic stem cell transplantation (Allo- HSCT) in CR1. The overall survival ( OS) was 43·4% at 1 year, and 16·3% at 5 years from relapse in patients who received chemotherapy alone in CR1. Among patients who relapsed after chemotherapy alone in CR1, 123 (52·5%) achieved a second remission ( CR2) following salvage chemotherapy, of whom 62 subsequently underwent Allo- HSCT during CR2. Allo- HSCT in CR2 was significantly associated with better OS. Moreover, the type of salvage chemotherapy influenced OS from relapse. A doxorubicin, vincristine, and predonisone-based (Ad VP-type) regimen was related to better OS in patients with longer CR1 (more than 1 year), but was related to worse OS in patients with shorter CR1. In conclusion, the prognosis of patients with relapsed Ph-negative ALL is poor. Allo- HSCT after a first relapse could improve the prognosis. Selection of the optimal salvage chemotherapy might depend on the duration of CR1.
- Subjects
LYMPHOBLASTIC leukemia; CHROMOSOMES; STEM cell transplantation; DRUG therapy; BONE marrow cells; DISEASE relapse
- Publication
British Journal of Haematology, 2013, Vol 161, Issue 1, p95
- ISSN
0007-1048
- Publication type
Article
- DOI
10.1111/bjh.12225