Abstract
We present 60 patients with refractory (n=8) or relapsed (n=52) adult ALL who received allogeneic hematopoietic SCT (HSCT) with (n=41) or without (n=19) prior reinduction chemotherapy. In our center, omission of reinduction is recommended if a suitable donor is promptly available, tumor burden is moderate and disease features suggest a highly aggressive course. Overall survival (OS) of the whole cohort at 1, 2 and 5 years was 42, 33 and 28%, respectively. Leukemia-free survival at 1, 2 and 5 years was 37, 33 and 24%. Deaths were due to relapse (n=25), acute or chronic GVHD (n=7), infections (n=8) or toxicity (n=4). Interestingly, patients who did not receive reinduction before HSCT had better outcomes than patients who received reinduction with OS at 1, 2 and 5 years being 58 vs 34%, 47 vs 25% and 47 vs 18%, respectively (P=0.039). Importantly, even achievement of a second CR after reinduction was not associated with improved survival compared to patients directly proceeding to HSCT. We conclude that patients who undergo HSCT for refractory or relapsed ALL can achieve long-term survival. In selected patients, reinduction chemotherapy can be omitted if immediate HSCT is feasible.
References
Nov 1, 1992·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·R A CliftJ Singer
Feb 1, 1992·Cancer·M FreundR Kuse
Jan 1, 1990·Annals of Oncology : Official Journal of the European Society for Medical Oncology·F GionaP Grotto
Nov 1, 1983·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·J R AndersonR D Gelber
Jun 1, 1997·British Journal of Haematology·F GionaF Mandelli
Mar 7, 1998·Bone Marrow Transplantation·J R PasswegA J Barrett
Jun 19, 1998·Bone Marrow Transplantation·R MartinoJ Sierra
Oct 3, 1999·Cancer·D A ThomasM J Keating
Dec 3, 1999·British Journal of Haematology·A P GriggJ Matthews
Dec 22, 1999·Leukemia·P BaderJ F Beck
Oct 6, 2000·Bone Marrow Transplantation·R H CollinsP Parker
Jan 9, 2001·Hematology/oncology Clinics of North America·N GökbugetD Messerer
Mar 10, 2001·Blood·J J CornelissenC Anasetti
Mar 20, 2001·Hematology/oncology Clinics of North America·G Garcia-Manero, D A Thomas
Mar 20, 2001·Hematology/oncology Clinics of North America·T G Martin, J L Gajewski
Sep 6, 2001·Blood·M UzunelO Ringdén
Jan 25, 2002·Blood·Luciana AnninoUNKNOWN GIMEMA Group
Feb 13, 2002·Leukemia·F R Appelbaum
Nov 26, 2002·Hematology·Dieter HoelzerTomasz Szczepański
Mar 14, 2003·Bone Marrow Transplantation·G MassenkeilR Arnold
Apr 30, 2003·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Stephanie J LeeMary E D Flowers
Jul 19, 2003·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Kristine DoneyRainer Storb
Dec 3, 2003·Annals of Hematology·Nicola Gökbuget, Dieter Hoelzer
Jul 28, 2005·Annals of Hematology·G SpecchiaV Liso
Aug 23, 2005·Bone Marrow Transplantation·G MassenkeilR Arnold
Nov 1, 2005·Bone Marrow Transplantation·A A OyekunleA R Zander
Jan 13, 2006·The New England Journal of Medicine·Ching-Hon Pui, William E Evans
Oct 13, 2006·Blood·Adele K FieldingUNKNOWN Eastern Cooperative Oncology Group
Nov 25, 2006·Hematology·Nicola Gökbuget, Dieter Hoelzer
Jan 16, 2008·Bone Marrow Transplantation·C LutzR Arnold
Citations
Apr 29, 2010·Current Hematologic Malignancy Reports·Theis H TerweyRenate Arnold
Mar 14, 2012·Current Hematologic Malignancy Reports·Partow Kebriaei, L M Poon
Sep 1, 2011·International Journal of Hematology·Kotaro AritaMasahiro Imamura
Aug 27, 2013·International Journal of Hematology·Xiaojin WuZhengzheng Fu
Dec 3, 2013·Bone Marrow Transplantation·P ChevallierM Mohty
Feb 25, 2010·International Journal of Hematology·Philipp G HemmatiRenate Arnold
Jul 6, 2014·Leukemia & Lymphoma·Françoise HuguetHervé Dombret
Aug 23, 2011·Leukemia & Lymphoma·Satoshi Nishiwaki, Koichi Miyamura
Oct 15, 2009·Hematology/oncology Clinics of North America·Farhad Ravandi, Partow Kebriaei
Jan 27, 2011·European Journal of Haematology·Philipp G HemmatiRenate Arnold
May 15, 2015·Blood·Noelle V Frey, Selina M Luger
Aug 2, 2011·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Denise M OlianskyTheresa Hahn
Oct 14, 2009·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Qi-Fa LiuHuo Tan
Aug 3, 2016·The Journal of Clinical Investigation·Partow KebriaeiLaurence J N Cooper
Jan 17, 2017·Annals of Hematology·Shin Hye YooUNKNOWN Korean Society of Blood and Marrow Transplantation
Feb 10, 2018·Frontiers in Immunology·Maliha KhanGheath Alatrash
Jul 19, 2019·Leukemia & Lymphoma·Prajwal DhakalVijaya Raj Bhatt
Jan 22, 2020·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Takayoshi TachibanaUNKNOWN Kanto Study Group for Cell Therapy (KSGCT)
Aug 7, 2021·Annals of Hematology·Takayoshi TachibanaUNKNOWN Kanto Study Group for Cell Therapy (KSGCT)