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The outcome of full-intensity and reduced-intensity conditioning matched sibling or unrelated donor transplantation in adults with Philadelphia chromosome–negative acute lymphoblastic leukemia in first and second complete remission

Marks, David I. ; Wang, Tao ; Pérez, Waleska S. ; Antin, Joseph H. ; Copelan, Edward ; Gale, Robert Peter ; George, Biju ; Gupta, Vikas ; Halter, Joerg ; Khoury, H. Jean ; Klumpp, Thomas R. ; Lazarus, Hillard M. ; Lewis, Victor A. ; McCarthy, Philip ; Rizzieri, David A. ; Sabloff, Mitchell ; Szer, Jeff ; Tallman, Martin S. ; Weisdorf, Daniel J.

Blood, 2010-07, Vol.116 (3), p.366-374 [Periódico revisado por pares]

Washington, DC: Elsevier Inc

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Título:
The outcome of full-intensity and reduced-intensity conditioning matched sibling or unrelated donor transplantation in adults with Philadelphia chromosome–negative acute lymphoblastic leukemia in first and second complete remission
Autor: Marks, David I. ; Wang, Tao ; Pérez, Waleska S. ; Antin, Joseph H. ; Copelan, Edward ; Gale, Robert Peter ; George, Biju ; Gupta, Vikas ; Halter, Joerg ; Khoury, H. Jean ; Klumpp, Thomas R. ; Lazarus, Hillard M. ; Lewis, Victor A. ; McCarthy, Philip ; Rizzieri, David A. ; Sabloff, Mitchell ; Szer, Jeff ; Tallman, Martin S. ; Weisdorf, Daniel J.
Assuntos: Adolescent ; Adult ; Aged ; Biological and medical sciences ; Busulfan - administration & dosage ; Clinical Trials and Observations ; Disease-Free Survival ; Female ; Graft vs Host Disease - etiology ; Graft vs Host Disease - prevention & control ; Hematologic and hematopoietic diseases ; Hematopoiesis ; Hematopoietic Stem Cell Transplantation - adverse effects ; Hematopoietic Stem Cell Transplantation - mortality ; Humans ; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis ; Lymphoid Neoplasia ; Male ; Medical sciences ; Melphalan - administration & dosage ; Middle Aged ; Multivariate Analysis ; Philadelphia Chromosome ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - genetics ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - mortality ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy ; Recurrence ; Registries ; Remission Induction ; Siblings ; Survival Analysis ; Tissue Donors ; Transplantation ; Transplantation Conditioning - adverse effects ; Transplantation Conditioning - methods ; Transplantation, Homologous ; Treatment Outcome ; Whole-Body Irradiation ; Young Adult
É parte de: Blood, 2010-07, Vol.116 (3), p.366-374
Descrição: We examined the efficacy of reduced-intensity conditioning (RIC) and compared outcomes of 93 patients older than 16 years after RIC with 1428 patients receiving full-intensity conditioning for allografts using sibling and unrelated donors for Philadelphia-negative acute lymphoblastic leukemia (ALL) in first or second complete remission. RIC conditioning included busulfan 9 mg/kg or less (27), melphalan 150 mg/m2 or less (23), low-dose total body irradiation (TBI; 36), and others (7). The RIC group was older (median 45 vs 28 years, P < .001) and more received peripheral blood grafts (73% vs 43%, P < .001) but had similar other prognostic factors. The RIC versus full-intensity conditioning groups had slightly, but not significantly, less acute grade II-IV graft-versus-host disease (39% vs 46%) and chronic graft-versus-host disease (34% vs 42%), yet similar transplantation-related mortality. RIC led to slightly more relapse (35% vs 26%, P = .08) yet similar age-adjusted survival (38% vs 43%, P = .39). Multivariate analysis showed that conditioning intensity did not affect transplantation-related mortality (P = .92) or relapse risk (P = .14). Multivariate analysis demonstrated significantly improved overall survival with: Karnofsky performance status more than 80, first complete remission, lower white blood count, well-matched unrelated or sibling donors, transplantation since 2001, age younger than 30 years, and conditioning with TBI, but no independent impact of conditioning intensity. RIC merits further investigation in prospective trials of adult ALL.
Editor: Washington, DC: Elsevier Inc
Idioma: Inglês

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The outcome of full-intensity and reduced-intensity conditioning matched sibling or unrelated donor transplantation in adults with Philadelphia chromosome–negative acute lymphoblastic leukemia in first and second complete remission

Washington, DC: Elsevier Inc

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