TY - JOUR
T1 - Reduced-intensity stem-cell transplantation for adult acute lymphoblastic leukemia
T2 - A retrospective study of 33 patients
AU - Hamaki, T.
AU - Kami, M.
AU - Kanda, Y.
AU - Kuji, K.
AU - Inamoto, Y.
AU - Kishi, Y.
AU - Nakai, K.
AU - Nakayama, I.
AU - Murashige, N.
AU - Abe, Y.
AU - Ueba, Y.
AU - Hino, M.
AU - Inoue, T.
AU - Ago, H.
AU - Hidaka, M.
AU - Hayashi, T.
AU - Yamane, T.
AU - Uoshima, N.
AU - Miyakoshi, S.
AU - Taniguchi, S.
PY - 2005/3
Y1 - 2005/3
N2 - Efficacy of reduced-intensity stem-cell transplantation (RIST) for acute lymphoblastic leukemia (ALL) was investigated in 33 patients (median age, 55 years). RIST sources comprised 20 HLA-identical related donors, five HLA-mismatched related, and eight unrelated donors. Six patients had undergone previous transplantation. Disease status at RIST was first remission (n = 13), second remission (n = 6), and induction failure or relapse (n = 14). All patients tolerated preparatory regimens and achieved neutrophil engraftment (median, day 12.5). Acute and chronic graft-versus-host disease (GVHD) developed in 45 and 64%, respectively. Six patients received donor lymphocyte infusion (DLI), for prophylaxis (n = 1) or treatment of recurrent ALL (n = 5). Nine patients died of transplant-related mortality, with six deaths due to GVHD. The median follow-up of surviving patients was 11.6 months (range, 3.5-37.3 months). The 1-year relapse-free and overall survival rates were 29.8 and 39.6%, respectively. Of the 14 patients transplanted in relapse, five remained relapse free for longer than 6 months. Cumulative rates of progression and progression-free mortality at 3 years were 50.9 and 30.4%, respectively. These findings suggest the presence of a graft-versus-leukemia effect for ALL. RIST for ALL is worth considering for further evaluation.
AB - Efficacy of reduced-intensity stem-cell transplantation (RIST) for acute lymphoblastic leukemia (ALL) was investigated in 33 patients (median age, 55 years). RIST sources comprised 20 HLA-identical related donors, five HLA-mismatched related, and eight unrelated donors. Six patients had undergone previous transplantation. Disease status at RIST was first remission (n = 13), second remission (n = 6), and induction failure or relapse (n = 14). All patients tolerated preparatory regimens and achieved neutrophil engraftment (median, day 12.5). Acute and chronic graft-versus-host disease (GVHD) developed in 45 and 64%, respectively. Six patients received donor lymphocyte infusion (DLI), for prophylaxis (n = 1) or treatment of recurrent ALL (n = 5). Nine patients died of transplant-related mortality, with six deaths due to GVHD. The median follow-up of surviving patients was 11.6 months (range, 3.5-37.3 months). The 1-year relapse-free and overall survival rates were 29.8 and 39.6%, respectively. Of the 14 patients transplanted in relapse, five remained relapse free for longer than 6 months. Cumulative rates of progression and progression-free mortality at 3 years were 50.9 and 30.4%, respectively. These findings suggest the presence of a graft-versus-leukemia effect for ALL. RIST for ALL is worth considering for further evaluation.
UR - https://www.scopus.com/pages/publications/20144386812
UR - https://www.scopus.com/pages/publications/20144386812#tab=citedBy
U2 - 10.1038/sj.bmt.1704776
DO - 10.1038/sj.bmt.1704776
M3 - Article
C2 - 15756282
AN - SCOPUS:20144386812
SN - 0268-3369
VL - 35
SP - 549
EP - 556
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
IS - 6
ER -